hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|GA,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Effingham Health System,2024-09-11,2.0.0,Effingham Health System,"459 GA-119 Springfield, GA 31329",51236,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,modifiers,standard_charge|AETNA|COMMERCIAL|negotiated_dollar,standard_charge|AETNA|COMMERCIAL|negotiated_percentage,standard_charge|AETNA|COMMERCIAL|negotiated_algorithm,estimated_amount|AETNA|COMMERCIAL,standard_charge|AETNA|COMMERCIAL|methodology,additional_payer_notes|AETNA|COMMERCIAL,standard_charge|AETNA|MEDICARE|negotiated_dollar,standard_charge|AETNA|MEDICARE|negotiated_percentage,standard_charge|AETNA|MEDICARE|negotiated_algorithm,estimated_amount|AETNA|MEDICARE,standard_charge|AETNA|MEDICARE|methodology,additional_payer_notes|AETNA|MEDICARE,standard_charge|AMERIGROUP|COMMERCIAL|negotiated_dollar,standard_charge|AMERIGROUP|COMMERCIAL|negotiated_percentage,standard_charge|AMERIGROUP|COMMERCIAL|negotiated_algorithm,estimated_amount|AMERIGROUP|COMMERCIAL,standard_charge|AMERIGROUP|COMMERCIAL|methodology,additional_payer_notes|AMERIGROUP|COMMERCIAL,standard_charge|BCBS|MEDICARE|negotiated_dollar,standard_charge|BCBS|MEDICARE|negotiated_percentage,standard_charge|BCBS|MEDICARE|negotiated_algorithm,estimated_amount|BCBS|MEDICARE,standard_charge|BCBS|MEDICARE|methodology,additional_payer_notes|BCBS|MEDICARE,standard_charge|BCBS|PPO|negotiated_dollar,standard_charge|BCBS|PPO|negotiated_percentage,standard_charge|BCBS|PPO|negotiated_algorithm,estimated_amount|BCBS|PPO,standard_charge|BCBS|PPO|methodology,additional_payer_notes|BCBS|PPO,standard_charge|BEECHSTREET|COMMERCIAL|negotiated_dollar,standard_charge|BEECHSTREET|COMMERCIAL|negotiated_percentage,standard_charge|BEECHSTREET|COMMERCIAL|negotiated_algorithm,estimated_amount|BEECHSTREET|COMMERCIAL,standard_charge|BEECHSTREET|COMMERCIAL|methodology,additional_payer_notes|BEECHSTREET|COMMERCIAL,standard_charge|CARESOURE|COMMERCIAL|negotiated_dollar,standard_charge|CARESOURE|COMMERCIAL|negotiated_percentage,standard_charge|CARESOURE|COMMERCIAL|negotiated_algorithm,estimated_amount|CARESOURE|COMMERCIAL,standard_charge|CARESOURE|COMMERCIAL|methodology,additional_payer_notes|CARESOURE|COMMERCIAL,standard_charge|CIGNA|COMMERCIAL|negotiated_dollar,standard_charge|CIGNA|COMMERCIAL|negotiated_percentage,standard_charge|CIGNA|COMMERCIAL|negotiated_algorithm,estimated_amount|CIGNA|COMMERCIAL,standard_charge|CIGNA|COMMERCIAL|methodology,additional_payer_notes|CIGNA|COMMERCIAL,standard_charge|HUMANA|COMMERCIAL|negotiated_dollar,standard_charge|HUMANA|COMMERCIAL|negotiated_percentage,standard_charge|HUMANA|COMMERCIAL|negotiated_algorithm,estimated_amount|HUMANA|COMMERCIAL,standard_charge|HUMANA|COMMERCIAL|methodology,additional_payer_notes|HUMANA|COMMERCIAL,standard_charge|HUMANA|MEDICARE|negotiated_dollar,standard_charge|HUMANA|MEDICARE|negotiated_percentage,standard_charge|HUMANA|MEDICARE|negotiated_algorithm,estimated_amount|HUMANA|MEDICARE,standard_charge|HUMANA|MEDICARE|methodology,additional_payer_notes|HUMANA|MEDICARE,standard_charge|MEDICAID|MEDICAID|negotiated_dollar,standard_charge|MEDICAID|MEDICAID|negotiated_percentage,standard_charge|MEDICAID|MEDICAID|negotiated_algorithm,estimated_amount|MEDICAID|MEDICAID,standard_charge|MEDICAID|MEDICAID|methodology,additional_payer_notes|MEDICAID|MEDICAID,standard_charge|MEDICARE|MEDICARE|negotiated_dollar,standard_charge|MEDICARE|MEDICARE|negotiated_percentage,standard_charge|MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|MEDICARE|MEDICARE,standard_charge|MEDICARE|MEDICARE|methodology,additional_payer_notes|MEDICARE|MEDICARE,standard_charge|MULTIPLAN_PHCS|COMMERCIAL|negotiated_dollar,standard_charge|MULTIPLAN_PHCS|COMMERCIAL|negotiated_percentage,standard_charge|MULTIPLAN_PHCS|COMMERCIAL|negotiated_algorithm,estimated_amount|MULTIPLAN_PHCS|COMMERCIAL,standard_charge|MULTIPLAN_PHCS|COMMERCIAL|methodology,additional_payer_notes|MULTIPLAN_PHCS|COMMERCIAL,standard_charge|PEACHSTATE|COMMERCIAL|negotiated_dollar,standard_charge|PEACHSTATE|COMMERCIAL|negotiated_percentage,standard_charge|PEACHSTATE|COMMERCIAL|negotiated_algorithm,estimated_amount|PEACHSTATE|COMMERCIAL,standard_charge|PEACHSTATE|COMMERCIAL|methodology,additional_payer_notes|PEACHSTATE|COMMERCIAL,standard_charge|THE_CARE_NETWORK|COMMERCIAL|negotiated_dollar,standard_charge|THE_CARE_NETWORK|COMMERCIAL|negotiated_percentage,standard_charge|THE_CARE_NETWORK|COMMERCIAL|negotiated_algorithm,estimated_amount|THE_CARE_NETWORK|COMMERCIAL,standard_charge|THE_CARE_NETWORK|COMMERCIAL|methodology,additional_payer_notes|THE_CARE_NETWORK|COMMERCIAL,standard_charge|UHC|COMMERCIAL|negotiated_dollar,standard_charge|UHC|COMMERCIAL|negotiated_percentage,standard_charge|UHC|COMMERCIAL|negotiated_algorithm,estimated_amount|UHC|COMMERCIAL,standard_charge|UHC|COMMERCIAL|methodology,additional_payer_notes|UHC|COMMERCIAL,standard_charge|UHC|MEDICARE|negotiated_dollar,standard_charge|UHC|MEDICARE|negotiated_percentage,standard_charge|UHC|MEDICARE|negotiated_algorithm,estimated_amount|UHC|MEDICARE,standard_charge|UHC|MEDICARE|methodology,additional_payer_notes|UHC|MEDICARE,standard_charge|UHC|PPO|negotiated_dollar,standard_charge|UHC|PPO|negotiated_percentage,standard_charge|UHC|PPO|negotiated_algorithm,estimated_amount|UHC|PPO,standard_charge|UHC|PPO|methodology,additional_payer_notes|UHC|PPO,standard_charge|WELLCARE|COMMERCIAL|negotiated_dollar,standard_charge|WELLCARE|COMMERCIAL|negotiated_percentage,standard_charge|WELLCARE|COMMERCIAL|negotiated_algorithm,estimated_amount|WELLCARE|COMMERCIAL,standard_charge|WELLCARE|COMMERCIAL|methodology,additional_payer_notes|WELLCARE|COMMERCIAL,standard_charge|min,standard_charge|max,additional_generic_notes
"TET, DIPTH, PERTUS (ADACEL, Tdap) 0.5ML",120,CDM,636,RC,,,both,,,98,63.7,,65.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.23,93.1,
ACETIC ACID OTIC SOLUTION,1012,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
CHARCOAL (ACTIDOSE AQUA) SUSP: 50GM,1014,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
CHARCOAL/SORB (ACTIDOSE) SUSP: 50GM,1015,CDM,637,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
FLUTICASON/SALMET(ADVAIR) 250/50MCG MDI,1020,CDM,637,RC,,,outpatient,,,262,170.3,,175.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,73.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,235.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,72.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,209.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,196.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,248.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,71.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,222.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.14,248.9,
OXYMETAZOLINE HCL (AFRIN) 0.05% NA SPRAY,1022,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
ALBUTEROL (PROVENTL) NEB INH: 2.5MG/3ML,1026,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PROPARACAINE (ALCAINE) 0.5% OPTH SOLN,1027,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
SPIRONOLACTONE (ALDACTONE) 25 MG TABLET,1030,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
GLIMEPIRIDE (AMARYL) TAB: 2MG,1041,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ZOLPIDEM (AMBIEN) 5 MG TABLET,1043,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ETOMIDATE (AMIDATE) INJECTION: 40mg,1046,CDM,250,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
AMMONIA INHALANT,1050,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
AMOXICILLIN (AMOXIL) 125 MG CHEWABLE TAB,1051,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
AMOXICILLIN (AMOXIL) 250 MG CAPSULES,1054,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
AMOXICILLIN (AMOXIL) 500 MG CAPSULE,1056,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
AMPICILLIN 250mg INJ,1057,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
AMPICILLIN 500 MG INJECTION,1058,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
ANTIVENIN BLACK WIDOW SPIDER INJECTION,1062,CDM,250,RC,,,outpatient,,,65,42.25,,43.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.4,61.75,
MECLIZINE (ANTIVERT) 25MG TABLET,1065,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
HYDROCORT ACETATE (ANUCORT-HC) SUPP 25MG,1066,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX PAMIDRONATE DISODIUM (AREDIA) 30MG IJ,1071,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
HYDRALazine (APRESOLINE) TAB: 25MG,1072,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
HYDRALazine (APRESOLINE) TAB: 10MG,1073,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DONEPEZIL (ARICEPT) TABLET: 5MG,1074,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ARTIFICIAL TEARS OPTH DROPS,1078,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
ASPIRIN 325 MG TABLET,1080,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ASPIRIN TABLET: 81MG,1082,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ASPIRIN *ENT.COATED* TAB: 81 MG,1083,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ASPIRIN  *ENT.COATED* TAB: 325 MG,1084,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
HYDROXyzine (ATARAX) 25MG TAB,1087,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LORAZEPAM (ATIVAN) TABLET:  0.5 MG,1089,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LORAZEPAM (ATIVAN) TABLET: 1 MG,1090,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LORAZEPAM (ATIVAN) TABLET: 2 MG,1091,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX ATROPINE 1MG/10ML ABBOJECT,1095,CDM,636,RC,,,both,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
AMOX/CLAV (AUGMENTN) 500MG/125MG TABLET,1107,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
AMOX/CLAV (AUGMENTIN) 875/125MG TB,1108,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
MOXIFLOXAC HCL/0.8% NACL PSL 400MG/250ML,1113,CDM,250,RC,,,outpatient,,,100,65,,67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.77,95,
MUPIROCIN (BACTROBAN) 2% OINTMT 22 GM,1120,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
DIPHENHYDRAMINE (BENADRYL) TAB: 25MG,1125,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DIPHENHYDRAMINE (BENADRYL) CAP: 50MG,1126,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DIPHENHYDRAMINE (BENADRYL) SOLN: 12.5 mg,1127,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DIPHENHYDRAMINE/ZINC (BENADRYL) CREAM,1128,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
DICYCLOMINE (BENTYL) CAPSULE: 10MG,1131,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ESMOLOL (BREVIBLOC) 100MG/10ML INJECTION,1147,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
VERAPAMIL (CALAN) INJ: 10MG/4 ML,1158,CDM,250,RC,,,outpatient,,,74,48.1,,49.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,66.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,59.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.81,70.3,
VERAPAMIL ER (CALAN SR) 120 MG TABS,1160,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
VERAPAMIL ER (CALAN SR) 180MG TABS,1161,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
CALCIUM CHLORIDE 10% ABBJ: 1GM/10ML,1164,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX CALCIUM GLUCONATE 10% 10ml INJECTION,1165,CDM,636,RC,,,both,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
DILTIAZEM (CARDIZEM) INJ: 25MG/5ML,1173,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
DILTIAZEM (CARDIZEM) TABLET: 30MG,1174,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DILTIAZEM (CARDIZEM) INJ: 50MG/10ML,1175,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
DILTIAZEM (CARDIZEM) TABLET: 60MG,1176,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DILTIAZEM EXT REL (CARDIZM CD) CAP:120MG,1177,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DILTIAZEM EXT REL (CARDIZM CD) CAP:180MG,1178,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DOXAZOSIN (CARDURA) TABLET: 2MG,1182,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
clonIDINE (CATAPRES) TABLET: 0.1MG,1183,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
clonIDINE (CATAPRES) TABLET: 0.2MG,1184,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
clonIDINE (CATAPRES) TABLET: 0.3MG,1185,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CLONIDINE (CATAPRES-TTS-1) PTCH: 0.1MG,1186,CDM,637,RC,,,outpatient,,,85,55.25,,56.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,76.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,72.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.75,80.75,
CLONIDINE (CATAPRES-TTS-2) PTCH: 0.2MG,1187,CDM,637,RC,,,outpatient,,,131,85.15,,87.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,98.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.07,124.45,
CEFUROXIME (CEFTIN) TABLETS: 250MG,1194,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
FOSPHENYTOIN (cereBYX) INJ: 100MG/2ML,1202,CDM,636,RC,,,both,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
LACTULOSE 20GM/30ML SOLUTION,1210,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
CIPROFLOXACIN (CILOXAN) OPTH DROP 2.5ML,1211,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
CIPROFLOXACIN (CIPRO) TABLET: 500MG,1216,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LORATADINE (CLARITIN) TABLET: 10 MG,1220,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CLINDAMYCIN (CLEOCIN) INJ: 300MG,1222,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX CLINDAMYCIN (CLEOCIN) INJ: 600MG,1224,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
BENZTROPINE (COGENTIN) TABLET: 1MG,1232,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DOCUSATE SODIUM (DOK) CAPSULE:100MG,1234,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DOCUSATE NA(COLACE) LIQUID: 100MG/10ML,1236,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
RX PROCHLORPERAZINE (COMPAZINE) TAB: 5MG,1240,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
AMIODARONE HCL (PACERONE) TABS 200MG,1243,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
CARVEDILOL (COREG) 3.125 MG TABLET,1245,CDM,637,RC,J3490,HCPCS,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CARVEDILOL (COREG) 6.25 MG TABLET,1246,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CARVEDILOL (COREG) TABLET: 12.5MG,1247,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CARVEDILOL  (COREG) TABLET: 25MG,1248,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NEO/POLY/BACI (NEOSPORIN) OPTH OIN 3.5,1253,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NEOMYCN/POLYM/HC (CORTISPORIN) OPTH SUSP,1254,CDM,637,RC,,,outpatient,,,151,98.15,,101.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,135.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,120.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,113.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,42.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,143.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,128.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.42,143.45,
NEO/POLYMY/HC (CORTISPORIN) OTIC SOLN,1255,CDM,637,RC,,,outpatient,,,187,121.55,,125.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,52.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,136.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,168.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,52.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,149.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,140.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,52.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,50.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,177.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,51.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,158.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.06,177.65,
NEO/POLYM/HC (CORTISPORIN) OTIC SUSP,1256,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
WARFARIN (COUMADIN) TABLET:  2 MG,1257,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
WARFARIN (COUMADIN) TABLET: 3 MG,1259,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
WARFARIN (COUMADIN) TABLET: 5 MG,1260,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
WARFARIN (COUMADIN) TABLET:  10 MG,1262,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ANTIVENIN CROTALIDAE PLY(CROFAB) 1GM INJ,1267,CDM,636,RC,,,both,,,5631.92,3660.75,,3773.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1576.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1507.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1576.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2815.96,50,,,percent of total billed charges,50% of billed charges for High Cost Drugs,5068.73,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1567.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4505.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4223.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1592.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1507.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1576.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5350.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1537.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4787.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3379.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1576.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3379.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1537.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1507.66,5350.32,
CVC KIT 2 LUMEN 4fr X 13cm PED,1270,CDM,272,RC,,,outpatient,,,45.6,29.64,,30.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.76,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.21,43.32,
CVC KIT 3 LUMEN (7fr X 20cm),1271,CDM,250,RC,,,outpatient,,,126,81.9,,84.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,113.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,35.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,100.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,94.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,35.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,33.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,119.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,34.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,107.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.73,119.7,
CYCLOPENTOLATE (CYCLOGYL) 1% OPTH SOLN,1280,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
DEXAMETHASONE (DECADRON) TABLET: 4MG,1303,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX DEXAMETHASON NA (DECADRON) SDV:4MG/ML,1306,CDM,636,RC,,,both,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
TORSEMIDE (DEMADEX) 5 MG TABLETS,1308,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
VALPROATE (DEPACON) 100MG/ML INJ: 500MG,1314,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
DIVALPROEX (DEPAKOTE) ER TAB:  250 MG,1316,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
DERMABOND/OCTYLSEAL applica. 0.4 mL,1317,CDM,270,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
METHYLPRD ACE (DEPO MEDROL) 80MG/ML MDV,1318,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
MEDROXYPROG ACE (DEPO PROVERA) 150MG INJ,1320,CDM,250,RC,,,outpatient,,,128,83.2,,85.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,115.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,35.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,102.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,96,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,34.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,108.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,76.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.27,121.6,
traZODONE HCL (DESYREL) 50 MG TABS,1323,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX IRON DEXTRAN 100MG/2ML INJECTION,1327,CDM,636,RC,,,both,,,70,45.5,,46.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,52.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,59.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.74,66.5,
DEXTROSE 50% (D50) INJECTION SYR 50 mL,1328,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
FLUCONAZOLE (DIFLUCAN) 100MG TABLET,1333,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
FLUCONAZOLE (DIFLUCAN) TABLET: 150MG,1334,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PHENYTOIN ER (DILANTIN) CAPSULE: 100MG,1339,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PHENYTOIN (DILANTIN) ORAL SUS:250MG/10ML,1344,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
PROPOFOL (DIPRIVAN) 10MG/ML INJ: 20 ML,1348,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
RX DOBUTAMINE (DOBUTREX) 250MG/20ML INJ,1352,CDM,636,RC,,,both,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
DOPAMINE INJECTION: 400MG/5ML,1354,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
BISACODYL (DULCOLAX) 5 MG TABLET,1357,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
BISACODYL (DULCOLAX) 10 MG  SUPPOSITORY,1359,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
HYDROCOLLOID DRESSNG (DUODERM CGF),1360,CDM,250,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
FENTANYL (DURAGESIC) PATCH: 75MCG/HR,1363,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
FENTANYL (DURAGESIC) PATCH: 25MCG/HR,1364,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
VENLAFAXINE XR (EFFEXOR XR) 37.5 MG CAPS,1374,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
AMITRIPTYLINE (ELAVIL) 10MG TABLET,1375,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
AMITRIPTYLINE (ELAVIL) 50 MG TABLET,1377,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
EPHEDRINE INJECTION: 50 MG/ML,1384,CDM,250,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
RX EPINEPHRINE INJ SYRINGE: 1MG/10ML,1386,CDM,636,RC,,,both,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
RX EPINEPHRINE INJECTION AMPULE: 1MG/ML,1388,CDM,636,RC,,,both,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
EYE WASH OPTH IRRIGATION 4 OZ,1405,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
FERROUS SULFATE TABLET: 325MG,1407,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
METRONIDAZOLE (FLAGYL) 500MG TABLET,1410,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
METRONIDAZOLE (FLAGYL) 500MG  PREMX IVPB,1412,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
FLEETS PEDIALAX PED ENEMA 2.25 OZ,1414,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
BALSAM ZINC (FLANDERS) 4 OZ OINT,1415,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
CYCLOBENZAPRINE (FLEXERIL) TAB: 10MG,1417,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
TAMSULOSIN (FLOMAX) 0.4 MG CAPS,1418,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
FLUTICASONE PROP (FLONASE) 50MCG SPRAY,1420,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
FLUORESCEIN NA (FLUOR-I-STRIP) 1MG STRIP,1427,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
FOLIC ACID TABLET: 1MG,1428,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
FOLIC ACID INJECTION MDV: 5 MG/ML,1430,CDM,250,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
GENTAMICIN SULFATE (GENTAK) 0.3% OINTMT,1437,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
GENTAMICIN SULFATE  0.3% OPTH DROP 5ML,1439,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
GI COCKTAIL 45 ML,1440,CDM,250,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
METFORMIN (GLUCOPHAGE) TAB: 500MG,1441,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
METFORMIN (GLUCOPHAGE) TAB: 1000MG,1442,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
gliPIZIDE (GLUCOTROL) 5 MG TABLET,1444,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
gliPIZIDE XL (GLUCOTROL XL) 2.5 MG TAB,1445,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
gliPIZIDE XL (GLUCOTROL XL) 5 MG TAB,1446,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
GLYCERIN ADULT SUPPOSITORY: 2GM,1449,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
GLYCERIN PEDIATRIC SUPPOSITORY: 1.2GM,1450,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PEG 3350/Electrolytes (GOLYTELY) 4LITER,1453,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
HALOPERIDOL (HALDOL) TABLET: 0.5MG,1454,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
HALOPERIDOL (HALDOL) TAB: 5MG,1457,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
HYDROCHLOROTHIAZIDE TABLET: 25 MG,1458,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ERYTHROMYCIN 0.5% OPTH OINT 3.5GM,1460,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
HYDROCORTISONE CREAM 2.5%,1462,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
INSULIN NPH (HUMULIN N) MDV: 100UNITS/ML,1471,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
INSULIN REG (HUMULIN R) MDV: 100UNITS/ML,1472,CDM,636,RC,,,both,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
SUMATRIPTAN (IMITREX) 100mg TAB,1482,CDM,637,RC,,,outpatient,,,61,39.65,,40.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.33,57.95,
ISOSORBIDE MONONITRT ER (IMDUR) 30MG TAB,1483,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ISOSORBIDE MONONITRT ER (IMDUR) 60MG TAB,1484,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LOPERAMIDE (IMODIUM) 1MG/7.5ML LIQUID,1486,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LOPERAMIDE (IMODIUM) 2MG CAPSULES,1487,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PROPRANOLOL HCL (INDERAL) 20 MG TABLET,1490,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
INDOMETHACIN (INDOCIN) CAPSULE: 25MG,1492,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
GLUCOSE (GLUTOSE 15) 40% ORAL GEL,1495,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
SODIUM POLYSTYRENE (KAYEXALATE) 15 GM,1506,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
CEPHALEXIN (KEFLEX) CAPSULE: 250MG,1508,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
clonAZEPAM (KLONIPIN) TABLET: 2MG,1510,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
clonAZEPAM (KLONIPIN) TABLET: 0.5MG,1511,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ARTIFICIAL TEARS OINT 3.5gm,1516,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
DIGOXIN (LANOXIN) TABLET: 0.125MG,1521,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
DIGOXIN (LANOXIN) TABLET: 0.25 MG,1522,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
INSULIN GLARGINE (LANTUS) MDV:100UNIT/ML,1525,CDM,637,RC,,,outpatient,,,192,124.8,,128.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,53.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,172.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,53.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,153.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,144,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,54.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,51.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,182.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,52.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.4,182.4,
FUROSEMIDE (LASIX) TABLET: 20MG,1526,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
FUROSEMIDE (LASIX) TABLET: 40MG,1528,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
FUROSEMIDE (LASIX) TABLET: 80MG,1530,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
BACLOFEN (LIORESAL) TABLET: 10 MG,1533,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NOREPINEPHRINE (LEVOPHED) 4MG/4ML INJ,1534,CDM,250,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
FLUOCINONIDE (LIDEX) 0.05% OINT 15GM,1541,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
LITHIUM CARB TABLET: 300 MG,1542,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ATORVASTATIN (LIPITOR) 10 MG TABLET,1547,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
ATORVASTATIN (LIPITOR) 40MG TABLETS,1548,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
DIPHENOXYLATE/ATROPINE (LOMOTIL) TABLET,1550,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
METOPROLOL tart. (LOPRESSOR) TAB: 50 MG,1552,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
METOPROLOL (LOPRESSOR) 5MG/5ML INJ,1553,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
CLOTRIMAZOLE (LOTRIMIN) 1% CRM 15GM,1562,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
METOPROLOL tart (LOPRESSOR) TAB: 25 MG,1564,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LUMBAR PUNCTURE TRAY (CHILD/INF),1570,CDM,272,RC,,,outpatient,,,25.8,16.77,,17.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.91,24.51,
LUMBAR PUNCTURE TRAY,1571,CDM,272,RC,,,outpatient,,,37.8,24.57,,25.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.02,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.91,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.12,35.91,
MAG/ALUM/SIME (MAALOX/MYLANTA) SUSP:30ML,1575,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
MAGNESIUM OXIDE (MAG-OX) 400MG TB,1579,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MAGNESIUM CITRATE SOLN  10OZ BOTTLE,1580,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
BUPIVACAINE (MARCAINE) 0.5% INJ 50ML,1585,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
TRIAMTER/HCTZ (MAXZIDE) 37.5/25MG TABLET,1592,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PSYLLIUM/SUCROSE (METAMUCIL) 12.2G PKT,1601,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
METHYLENE BLUE 1% 1ml AMP,1604,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
glyBURIDE (MICRONASE) TAB: 5MG,1612,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MAG HYDROX (MOM) SUSP:  2400MG/30ML,1614,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
MINERAL OIL 30ML,1615,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PEG 3350 (MIRALAX) 255gm **BOTTLE**,1622,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
MICONAZOLE NITRATE (MONISTAT 7) 2% CRM,1627,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
MORPHINE SULFATE 1 MG/ML PCA 30 ML,1638,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
IBUPROFEN (MOTRIN) TABLET: 400 MG,1639,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
IBUPROFEN (MOTRIN) TABLET: 600 MG,1640,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
IBUPROFEN (MOTRIN) TABLET: 800 MG,1641,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
IBUPROFEN (MOTRIN) 100MG/5ML SUSP,1642,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
IBUPROFEN (MOTRIN) SUSP UD: 100MG/5ML,1643,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
MULTIVITAMIN  CAPSULE,1644,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MULITVITAMIN INJECTION (INFUVITE) 10 ML,1645,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
SIMETHICONE (MYTAB GAS) CHEW 80MG,1652,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
SIMETHICONE (MYLICON) 40MG/0.6ML DROPS,1655,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NAPROXEN (NAPROSYN) 500MG TABLET,1668,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NALOXONE (NARCAN) 0.4 MG/ML INJ,1670,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
NEOMY/POLYMYX/GRAM (NEOSPORIN) OPTH SOLN,1679,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NEOM/POLYM/DEX (POLY-DEX) OPTH OINT 3.5G,1682,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
GABAPENTIN (NEURONTIN) CAPSULE: 300MG,1683,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
GABAPENTIN (NEURONTIN) CAPSULE: 100MG,1684,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NICOTINE TRANSDERMAL 14MG/24HR PATCH,1689,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NICOTINE TRANSDERMAL PTCH 21MG/24HR,1690,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NITROGLYCERIN (NITRO-BID) 2% OINT: 1GM,1699,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NITROGLYCERIN (NITRODUR) 0.4MG/HR PATCH,1705,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
NITROGLYCERIN 50MG/10ML SDV,1707,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NITROGLYCERIN (NITROQUICK) 0.4MG TABLET,1717,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
KETOCONAZOLE (NIZORAL) 2% CREAM 15gm,1718,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NORMAL SALINE 50ml PF,1722,CDM,258,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
NORMAL SALINE 100ML PF,1725,CDM,258,RC,,,outpatient,,,14,9.1,,9.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.75,13.3,
LABETALOL HCL (NORMODYNE) 200 MG TABLET,1739,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
AMLODIPINE (NORVASC) 10MG TABLET,1747,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
"NYSTATIN 100,000 UNITS/GM CREAM 15GM",1763,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
CALCIUM OSYTER SHELL (OSCAL) 500 MG TAB,1773,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OXYCODONE ER (OXYCONTIN) TAB *CII*: 10MG,1774,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
P.E.G. KIT,1775,CDM,270,RC,,,outpatient,,,158.7,103.16,,106.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,44.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,142.83,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,44.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,126.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,119.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,44.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,42.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,43.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,95.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.48,150.77,
OXYCODONE ER (OXYCONTIN) TAB *CII*: 20MG,1776,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
PARACENTESIS TRAY,1783,CDM,250,RC,,,outpatient,,,116,75.4,,77.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,32.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,104.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,92.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,98.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,69.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.05,110.2,
BROMOCRIPTINE (PARLODEL) 2.5 MG TABLETS,1785,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
PARoxetine HCL (PAXIL) 20 MG TABLET,1791,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
FAMOTIDINE (PEPCID) TABLET: 20MG,1813,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OXYCODONE/APAP (PERCOCET) TAB: 5/325MG,1817,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PROMETHAZINE (PHENERGAN) 25MG TABLET,1849,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PROMETHAZINE (PHENERGAN) 25MG SUPPOSITRY,1850,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
PHENOBARBITAL 32.4 MG TABLET,1863,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PHENOL LIQUID 60ml,1872,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
CLOPIDOGREL (PLAVIX) TABLET: 75MG,1879,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
BACITRACIN/POLYM (POLYSPORIN) OINTMT 15G,1887,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
PRAVASTATIN (PRAVACHOL) TABLET: 40MG,1907,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PREDNISONE (DELTASONE) TABLET: 10 MG,1913,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PREDNISONE (DELTASONE) TABLET: 20 MG,1915,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OMEPRAZOLE SR (PRILOSEC) CAP: 20 MG,1947,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LISINOPRIL (PRINIVIL) 10 MG TABLET,1953,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NIFEDIPINE XL (PROCARDIA XL) 30MG TABLET,1967,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
RX PROTAMINE SULFATE 10MG/ML INJ: 250MG,2005,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
ALBUTEROL SULF (VENTOLIN ) 2MG/5ML SYRUP,2015,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ALBUTEROL (VENTOLIN HFA) MDI: 90MCG/ACT,2017,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
MEDROXYPROGESTERONE (PROVERA) TAB: 10MG,2023,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX RABIES IMMUNE GLOB (HYPERRAB) 10ML IJ,2038,CDM,250,RC,,,outpatient,,,506,328.9,,339.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,141.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,141.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,369.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,455.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,140.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,404.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,379.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,143.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,135.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,141.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,480.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,138.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,430.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,303.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,303.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,135.46,480.7,
METOCLOPRAMIDE HCL (REGLAN) 10 MG TABLET,2047,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
METOCLOPRAMIDE HCL (REGLAN) 5 MG TABLET,2049,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NABUMETONE (RELAFEN) 500 MG TABLET,2053,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
TEMAZEPAM (RESTORIL) 15mg CAPSULE,2061,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RISPERIDONE (RISPERDAL) TABLET: 1MG,2077,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
GLYCOPYRROLATE (ROBINUL) 0.2mg/mL INJ,2083,CDM,250,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
GUAIF/DM (ROBITUSSIN DM) SYRUP: 10ML,2097,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
FLUMAZENIL (ROMAZICON) INJ: 0.5MG/5ML,2100,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
SALINE 0.65% NASAL SPRAY 45 ML,2119,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
SULFAMETHOX/TMP(SEPTRA DS) TAB:800/160MG,2133,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
SULFAM/TRIMETH (SEPTRA) 200/40MG/5ML SUS,2135,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
QUETIAPINE (SEROQUEL) 25 MG TABLET,2138,CDM,637,RC,J3490,HCPCS,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
QUETIAPINE (SEROQUEL) 100MG TABLET,2140,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
SILVER SULFADIAZINE (THERMAZENE) CRM 1%,2141,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
SILVER NITRATE (ARZOL) APPLICATORS,2143,CDM,250,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
DOXEPIN (SINEQUAN) 25MG CAPSULE,2153,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MONTELUKAST (SINGULAIR) 10 MG TABLET,2161,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
SODIUM BICARBONATE LSSY 0.5MEQ/ML(PEDS),2167,CDM,250,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
SODIUM BICARB 8.4% (1 MEQ/ML) 50 ML SYR,2169,CDM,250,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
PSEUDOEPHEDRINE (SUDAFED) 30MG TAB,2177,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
SPINAL ANESTHESIA TRAY,2180,CDM,250,RC,,,outpatient,,,98,63.7,,65.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.23,93.1,
LEVOTHYROXINE (SYNTHROID) TAB: 88MCG,2181,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
SULFACETAMIDE NA 10% OPTH SOLUTION,2185,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
SURGICEL 4x8 ABSORABLE HEMOSTAT,2187,CDM,637,RC,,,outpatient,,,201,130.65,,134.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,180.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,160.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,150.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.81,190.95,
LEVOTHYROXINE (SYNTHROID) 75 MCG TABLET,2189,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LEVOTHYROXINE SOD INJECTION: 100MCG/VIAL,2190,CDM,250,RC,,,outpatient,,,130,84.5,,87.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.8,123.5,
LEVOTHYROXINE (SYNTHROID) 125 MCG TAB,2191,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LEVOTHYROXINE (SYNTHROID) 100MCG TAB,2193,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OSELTAMIVIR (TAMIFLU) 75 MG CAPSULE,2197,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
METHIMAZOLE (TAPAZOLE) 5 MG TABLETS,2198,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CARBAMAZEPINE (TEGRETOL) TABLET:  200MG,2202,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ATENOLOL (TENORMIN) 50 MG TABLETS,2210,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
BENZONATATE (TESSALON) CAPSULE: 100 MG,2211,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
TETRACAINE 0.5% OPTH SOLUTION,2215,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
THIAMINE HCL (VITA B1) 100 MG TABLET,2220,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX THIAMINE HCL (VIT B1) 100MG/ML INJ,2221,CDM,636,RC,,,both,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
THORACENTESIS TRAY,2222,CDM,250,RC,,,outpatient,,,106,68.9,,71.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,95.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,84.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,79.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,90.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.38,100.7,
chlorproMAZINE (THORAZINE) INJ: 25MG/ML,2224,CDM,250,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
RX TOBRAMYCIN 80MG INJECTION,2234,CDM,636,RC,,,both,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
TOBRAMYCIN (TOBREX) 0.3% OPTH SOLUTION,2236,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
METOPROLOL  succ XL (TOPROL XL) TAB:50MG,2238,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
TRIAMCINOLONE (KENALOG) 0.1% CREAM 15 GM,2245,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
TRIPLE DYE PIN POINT APPLICATOR,2249,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CALCIUM CARBONATE (TUMS) 500 MG TAB,2250,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ACETAMIN/CODEIN 300/30MG (TYLENOL #3) TB,2251,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ACETAMINOPHEN (TYLENOL) 325 MG TABLET,2254,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CODEINE/ACETAM ELIXIR: 12MG/120MG/5ML,2259,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
ACETAMINOPHEN (TYLENOL) 120MG SUPPOSITOR,2261,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
ACETAMINOPHEN (TYLENOL) 80MG SUPP,2262,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
ACETAMINOPHEN/CODEINE ELIXIR: 5ML,2263,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
traMADOL (ULTRAM) TABLET:  50MG,2267,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
BETHANEHOL (URECHOLINE) 10mg TABLET,2272,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
BETHANECHOL (URECHOLINE) 25MG TB,2274,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DIAZEPAM (VALIUM) TABLET: 2MG,2278,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DIAZEPAM (VALIUM) TABLET: 5MG,2279,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ENALAPRILAT (VASOTEC) INJ: 1.25MG/ML,2283,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
ASCORBIC ACID (VITAMIN C) 500MG TABLET,2310,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
WATER FOR IRRIGATION 1000ML,2316,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
bupropion SR (wellbutrin SR) 150MG TAB,2317,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
ALPRAZOLAM (XANAX) TABLET: 0.25 MG,2324,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ALPRAZOLAM (XANAX) TABLET: 0.5 MG,2325,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LIDOCAINE HCL (XYLOCAINE) 2% JELLY 5ml,2332,CDM,250,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
LIDOCAINE VISCOUS 2% SOLN 15 ML UD CUP,2334,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
TIZANIDINE HCL (ZANAFLEX) 4MG TABLET,2336,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
METOLAZONE (ZAROXOLYN) 2.5 MG TABLET,2342,CDM,250,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
BISOPROLOL (ZEBETA) 5 MG TABLET,2344,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
BISPROLOL/HCTZ (ZIAC) 5MG/6.25MG TABLET,2346,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
AZITHROMYCIN (ZITHROMAX) 100MG/5ML SUSP,2352,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
AZITHROMYCIN (ZITHROMAX) 200MG/5ML SUSP,2353,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
AZITHROMYCIN (ZITHROMAX) TABLET: 250MG,2354,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
SIMVASTATIN (ZOCOR) TABLET: 10 MG,2357,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
SIMVASTATIN (ZOCOR) TABLET: 40 MG,2359,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ROCURONIUM (ZEMURON) INJ: 50MG/5ML,2360,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX PIPERACILLIN/TAZOB (ZOSYN) INJ:2.25GM,2364,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
ACYCLOVIR (ZOVIRAX) 200mg CAP,2369,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OLANZAPINE (ZYPREXA) TABLET: 2.5mg,2375,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
OLANZAPINE (ZYPREXA) 2.5 MG TABLET,2378,CDM,259,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
PANTOPRAZOLE (PROTONIX) TABLET: 40MG,2386,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
HYDROmorphone (DILAUDID) TABLET: 2MG,2390,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
HYDROmorphone (DILAUDID) INJ: 1MG/ML,2392,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
LABETALOL (TRANDATE) MDV INJ: 100MG/20ML,2410,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
INSULN LIS MIX (HUMALG 75/25):100UNIT/ML,2505,CDM,250,RC,,,outpatient,,,130,84.5,,87.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.8,123.5,
ONDANSETRON (ZOFRAN) ODT TAB: 4 MG,2512,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LEVETIRACETAM (KEPPRA) SOLN: 500MG/5ML,2530,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
ROSUVASTATIN (CRESTOR) TABLET: 10 MG,2534,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX ALTEPLASE (ACTIVASE;tpa) 100mg INJ,2536,CDM,636,RC,,,both,,,17284,11234.6,,11580.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4839.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4626.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4839.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8642,50,,,percent of total billed charges,50% of billed charges for High Cost Drugs,15555.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4812.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13827.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12963,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4887.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4626.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4839.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16419.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4719.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14691.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10370.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4839.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10370.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4719.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4626.93,16419.8,
bupropion XL (wellbutrin XL) 150MG TAB,2552,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
PREGABALIN (LYRCIA) 75mg CAPSULE,2556,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
LAC HYDRIN 12% LOTION 8oz,2564,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
ESCITALOPRAM (LEXAPRO) TAB: 10MG,2576,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
DUTASTERIDE (AVODART) GELCAP: 0.5MG,2581,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
CILOSTAZOL (PLETAL) TABLET: 100MG,2588,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
HYOSCYAMINE (LEVSIN) 0.125mg TABLET,2594,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
CHOLESTYRAMINE LIGHT (QUESTRAN) PWD: 4GM,2598,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
HYDROCORTISONE 1% CREAM,2600,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
"NYSTATIN SUSPENSION: 500,000UNITS/5ML",3760,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
LIDOCAINE 1% INJECTION: 10 MG/ML,15432,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX RABIES VACCINE INJECTION:  2.5 UNITS,25051,CDM,250,RC,,,outpatient,,,602,391.3,,403.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,168.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,168.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,439.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,541.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,167.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,481.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,451.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,170.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,161.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,168.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,571.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,164.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,511.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,161.16,571.9,
POLYMYXIN/TRIMET (POLYTRIM) EYE GTT 10ML,31510,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
PREGABALIN (LYRICA) 50MG CAPSULE,40271,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX ZOLEDRONIC ACID (RECLAST) 5MG INJ,43561,CDM,636,RC,,,both,,,440,286,,294.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,123.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,321.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,396,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,122.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,352,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,330,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,124.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,117.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,418,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,120.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,374,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,117.79,418,
SPINAL PUNCTURE LUMBAR DIAG,62270,CDM,360,RC,,,outpatient,,,440.6,286.39,,295.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,123.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,321.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,396.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,122.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,352.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,330.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,124.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,117.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,418.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,120.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,374.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,264.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,264.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,117.95,418.57,
ATROPINE 0.25MG/5ML PED INJ SYRINGE,104157,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
TOLTERODINE 1MG (DETROL 1MG) TAB,400155,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
ESTRADIOL (ESTRACE) TABLET: 1MG,400167,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX LIDOCAINE HCI 100MG/5ML IV SYRINGE,401002,CDM,636,RC,,,both,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
RX PNEUMOCOCCAL VAX (PNEUMOVAX 23) INJ,401003,CDM,636,RC,,,both,,,158,102.7,,105.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,142.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,126.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,118.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,44.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,42.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,43.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.3,150.1,
VALPROIC ACID (DEPAKENE) 250MG/5ML syrp,401004,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CARBAMIDE PEROXIDE (DEBROX) EAR DROPS,401005,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
FENTANYL (DURAGESIC) PATCH: 50MCG/HR,401006,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
ACETAMINOPHEN (TYLENOL) SUSP: 160MG/5ML,401009,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
THIORIDAZINE (MELLARIL) TABLET: 25 MG,401010,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NITROFURANTOIN (MACRODANTIN) 50MG CAPS,401011,CDM,250,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
POTASSIUM (KLOR CON) TABLET:  20MEQ,401015,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX IRON SUCROSE (VENOFER) INJ: 100mg,401016,CDM,636,RC,,,both,,,80,52,,53.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.42,76,
PROMETHAZINE W/CODEINE 10 ML SYP,401017,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RIVASTIGMINE (EXELON) 1.5MG CAPSULES,401019,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
GABAPENTIN (NEURONTIN) CAPSULE: 400MG,401020,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ISOSORBIDE MONONITRATE (ISMO) 20MG TB,401021,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
TERAZOSIN (HYTRIN) 1 MG CAPSULE,401026,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX HEPARIN 5000UNITS/ML INJECTION,401030,CDM,636,RC,,,both,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
FISH OIL (OMEGA 3) SOFTGEL: 1000MG,401034,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
STERILE WATER FOR INJ 1000 ML,401035,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
ZINC OXIDE OINTMENT 1 OZ,401036,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
HYDROXYCHLOROQUINE (PLAQUENIL) 200 MG TB,401037,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RACEMIC EPINEPHRINE 2.25% INHALATION,401038,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
DOXYCYCLINE (VIBRAMYCIN) CAPSULE: 100MG,401039,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
FENTANYL (DURAGESIC) PATCH: 100MCG/HR,401045,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
MORPHINE ER (MS CONTIN) 15MG TABLET,401047,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
SODIUM POLYS (KAYEXALATE) 30GM *RECTAL,401048,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
PHYTONADIONE (VITAMIN K) *1mg/0.5ml* INJ,401049,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX AMPICILLIN/SULBACTAM (UNASYN) 3GM INJ,401051,CDM,636,RC,,,both,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
ALCOHOL (ISOPROPYL) 70% BOTTLE,401054,CDM,250,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
BISOPROLOL/HCTZ (ZIAC) 10/6.25 MG TAB,401057,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PHOS-NaK (NEUTRA PHOS) POWR PACKET,401058,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PEG 3350 (MIRALAX) PACKET:  17 GM,401060,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
FLUDROCORTISONE (FLORINEF) TAB: 0.1MG,401061,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
STERILE WATER INJ 2000ML,401063,CDM,258,RC,,,outpatient,,,120,78,,80.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,108,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.12,114,
FLUTICASONE (FLOVENT) HFA 110MCG MDI,401064,CDM,637,RC,,,outpatient,,,317,206.05,,212.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,88.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,88.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,231.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,285.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,88.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,253.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,237.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,89.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,84.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,88.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,301.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,86.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,269.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,190.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.86,301.15,
ACETYLCYSTEINE (MUCOMYST) 20% VIAL: 30ML,401068,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
CLINDAMYCIN (CLEOCIN) CAPSULE: 150MG,401072,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PREDNISOLONE 1% (PRED FORTE) EYE DROPS,401073,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
VITAMIN D 1000 UNITS CAPS,401077,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
INSULIN LIS MIX (HUMALG 50/50):100UNIT/M,401079,CDM,250,RC,,,outpatient,,,130,84.5,,87.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.8,123.5,
MANNITOL 25% INJ 12.5GM/50ML,401080,CDM,250,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
RHO-D IMMUNE GLOBULIN (RHOGAM) 300 MCG,401081,CDM,250,RC,,,outpatient,,,165,107.25,,110.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,132,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.17,156.75,
MEDROXYPROGESTERONE (PROVERA) TAB: 2.5MG,401084,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
ACETAMINOPHEN SUSP: 650MG/20.3ML,401086,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
"NYSTATIN OINTMENT 100,000UNITS/GM",401094,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
HUMULIN 70/30 (NOVOLN 70/30):100UNITS/ML,401095,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
MORPHINE (ROXANOL) ORAL SOLN: 10MG/0.5ML,401098,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
MORPHINE IMMEDIATE REL (MS IR) 15 MG TAB,401101,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CHOLESTYRAMINE (QUESTRAN) POWDR: 4GM,401102,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
DOXEPIN (SINEQUAN) CAPSULE: 10MG,401103,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NITROGLYCERIN (NITRODUR) 0.1 MG/HR PATCH,401106,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
PRIMIDONE (MYSOLINE) 50 MG TABLET,401107,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PREDNISONE (DELTASONE) TABLET: 1 MG,401108,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NORMAL SALINE 1000ML IRRIGATION,401109,CDM,258,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
RIFAMPIN 150 MG CAPSULE,401110,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
LUBRIDERM LOTION 6 OZ BOTTLE,401112,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX FLUCONAZOLE 200MG/100ML PREMIX,401114,CDM,636,RC,,,both,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
RX Leuprolide{6 X 7.5 mg} 45mg SUBQ INJ,401116,CDM,636,RC,,,both,,,294,191.1,,196.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,82.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,214.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,264.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,81.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,235.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,220.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,78.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,279.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,80.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,249.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,78.7,279.3,
ACYCLOVIR (ZOVIRAX) 500 MG INJECTION,401122,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
FINASTERIDE (PROSCAR) TABLET: 5MG,401123,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
AMINOCAPROIC ACID (AMICAR) 5GM/20ML INJ,401124,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
"RX HEPARIN/0.45NS PREMX:25,000UNIT/500ML",401125,CDM,636,RC,,,both,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
WATER FOR INJECTION 20 ML VIAL,401127,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
PENICILLIN G POTASSIUM 5MILUNIT INJ VIAL,401128,CDM,250,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
GUAIF/DM (MUCINEX DM) TABLET: 600MG/30MG,401129,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
AMOX/CLAV (AUGMENTIN) 200/28.5MG/5ML SUS,401130,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
CHLORHEXIDINE 0.12% (PERIDEX) RINSE:16OZ,401131,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
SODIUM CHLORIDE 0.9% INH 3ML AMP,401134,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
FENTANYL (DURAGESIC) PATCH: 12MCG/HR,401135,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
BETAMETHASONE (DIPROLENE) 0.05% CRM 15GM,401139,CDM,637,RC,,,outpatient,,,63,40.95,,42.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,56.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.87,59.85,
PIPERONYL/PYRETHRUM (RID) SHAMPOO,401142,CDM,637,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
NORMAL SALINE 100 ML +PLUS BAG,401143,CDM,258,RC,,,outpatient,,,14,9.1,,9.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.75,13.3,
RX PHENYTOIN (DILANTIN) 250MG/5ML INJ,401144,CDM,636,RC,,,both,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
RX CEFUROXIME (ZINACEF) INJECTION: 750MG,401148,CDM,636,RC,,,both,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
ALBUT/IPRAT (DUONEB) INH: 2.5/0.5MG/3ML,401151,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
TETRAHYDROZALINE (VISINE) EYE DROPS 15ML,401153,CDM,250,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
ACETIC ACID 0.25% 1000ML IRRIGATION,401158,CDM,258,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
D5W 100ML,401159,CDM,258,RC,,,outpatient,,,14,9.1,,9.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.75,13.3,
WATER GALLON BOTTLE,401165,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
WATER FOR IRRIGATION 500ML,401166,CDM,258,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NORMAL SALINE 250ML PF,401167,CDM,258,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
HUMALOG SLIDING SCALE INSULIN,401169,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
HUMULIN R INSULIN SLIDING SCALE,401170,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
BISOPROLOL/HCTZ (ZIAC) 2.5/6.5MG TABLETS,401173,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
SODIUM CHLORIDE 50ML MINIBAG PLUS,401175,CDM,250,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
NF-ACCUPRIL TABLET 20MG,401185,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NF-FOSINOPRIL SODIUM TAB 10MG,401198,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-VIOKASE 8 TABLETS,401199,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-DEMECLOCYCLINE HCL TAB 300MG,401200,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-RAMIPRIL CAP 5MG,401201,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-BENICAR ORAL TABLET 20MG,401213,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NF-AVAPRO TAB 150MG,401228,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-ALLEGRA-D 12 HOUR TAB ER 60MG-120MG,401234,CDM,259,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NF-ACCUPRIL TABLET 5MG,401240,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NF-ZOMIG TAB 2.5MG,401250,CDM,637,RC,,,outpatient,,,57,37.05,,38.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.26,54.15,
NF-MICARDIS ORAL TABLET 40MG,401268,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-ASACOL TABLET 400MG,401292,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
VANCOMYCIN (VANCOCIN) 500MG INJECTION,401300,CDM,636,RC,,,both,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
VENLAFAXINE (EFFEXOR) 75 MG TABLETS,401302,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
PANTOPRAZOLE (PROTONIX) 40 MG POWDER PAC,401304,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NF-PERMETHRIN LOTION 1%,401323,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-PERMETHRIN TOPICAL CREAM 5%,401324,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-PAXIL CR TAB ER 12.5MG,401326,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-PAXIL CR TAB ER 25MG,401327,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-OASIS MOISTURIZING MM SPRAY 35%,401330,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
HYDROcodone/APAP 5/325MG TABLET,401334,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CHLORHEXIDINE (HIBICLENS) 32 OZ BOTTLE,401336,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-NORTRIPTYLINE HCL CAP 25MG,401337,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX CEFEPIME (MAXIPIME) 1 GM INJECTION,401342,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
D5W 500 ML VISIV BAG,401359,CDM,250,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
HEMORRHOIDAL OINTMENT 57GM TUBE,401364,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
ETHAMBUTOL (MYAMBUTOL) 100 MG TABLET,401370,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MEBENDAZOLE (VERMOX) 100 MG TABLET,401371,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
STERILE WATER FOR INJ 500 ML,401375,CDM,250,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
HYDROcodone/APAP 7.5/325MG TAB,401377,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX HALOPERIDOL DECANOATE 100MG/ML INJ,401379,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
RX RABIES IMMUNE GLOB (HYPERRAB) 2ML INJ,401382,CDM,250,RC,,,outpatient,,,924,600.6,,619.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,247.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,674.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,831.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,257.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,739.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,693,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,261.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,247.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,877.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,252.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,785.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,554.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,554.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,247.35,877.8,
NF-SCOT-TUSSIN DM ORAL SOLN 2MG-15MG/5ML,401385,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-MEPERITAB TAB 50MG,401386,CDM,637,RC,,,outpatient,,,0.6,0.39,,0.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.16,0.57,
NF-CHLORZOXAZONE ORAL TABLET 500MG,401387,CDM,637,RC,,,outpatient,,,2.55,1.66,,1.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.91,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.68,2.42,
NF-DANTROLENE SODIUM CAP 25MG,401388,CDM,637,RC,,,outpatient,,,3.21,2.09,,2.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.57,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.86,3.05,
NF-ONGLYZA ORAL TABLET 5MG,401389,CDM,637,RC,,,outpatient,,,24.36,15.83,,16.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.52,23.14,
NF-RYTHMOL ORAL TABLET 150MG,401390,CDM,637,RC,,,outpatient,,,13.87,9.02,,9.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.71,13.18,
NF-RYTHMOL SR CAP ER 325MG,401391,CDM,637,RC,,,outpatient,,,25.67,16.69,,17.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.39,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.87,24.39,
NF-ARMOUR THYROID TABLET 60MG,401394,CDM,637,RC,,,outpatient,,,0.63,0.41,,0.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.57,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.17,0.6,
NF-LUNESTA TAB 2MG,401395,CDM,637,RC,,,outpatient,,,27.59,17.93,,18.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.83,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.39,26.21,
NF-VESICARE ORAL TABLET 10MG,401398,CDM,637,RC,,,outpatient,,,19.42,12.62,,13.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.2,18.45,
NF-RANITIDINE HCL TAB 150MG,401401,CDM,637,RC,,,outpatient,,,6.9,4.49,,4.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.85,6.56,
NF-DOCUSATE CALCIUM LIQ CAP 240MG,401402,CDM,637,RC,,,outpatient,,,0.26,0.17,,0.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.21,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.07,0.25,
NF-DIOVAN HCT ORAL TABLET 320MG-12.5MG,401403,CDM,637,RC,,,outpatient,,,14.33,9.31,,9.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.84,13.61,
NF-KEPPRA ORAL TABLET 500MG,401404,CDM,637,RC,,,outpatient,,,16.79,10.91,,11.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.43,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.49,15.95,
SEVOFLURANE (ULTANE) INHALATION ANEST,401405,CDM,250,RC,,,outpatient,,,252,163.8,,168.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,70.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,70.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,183.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,226.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,70.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,201.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,189,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,71.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,67.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,70.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,239.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,68.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,214.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,151.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,151.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.46,239.4,
HYDROcodone/APAP 10MG/325MG TAB,401406,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-ORPHENADRINE CITRATE ORAL TAB ER 100M,401407,CDM,637,RC,,,outpatient,,,8.58,5.58,,5.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.3,8.15,
SODIUM BICARBONATE 8.4% INJ VIAL: 50MEQ,401408,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-ACCURETIC TAB 25MG-20MG,401411,CDM,637,RC,,,outpatient,,,6.35,4.13,,4.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,6.03,
NF-TRICOR ORAL TABLET 145MG,401412,CDM,637,RC,,,outpatient,,,18.71,12.16,,12.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.01,17.77,
NF-NITROSTAT SL TAB 0.4MG,401413,CDM,637,RC,,,outpatient,,,0.26,0.17,,0.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.21,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.07,0.25,
NF-ZOFRAN INJECTION   2MG/ML,401414,CDM,637,RC,,,outpatient,,,38.46,25,,25.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.61,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.77,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.3,36.54,
NF-DIOVAN HCT ORAL TABLET 320MG-25MG,401415,CDM,637,RC,,,outpatient,,,16.31,10.6,,10.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.05,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.37,15.49,
NF-ZAROXOLYN TABLET 5MG,401417,CDM,637,RC,,,outpatient,,,7.1,4.62,,4.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.04,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.9,6.75,
NF-LYRICA CAP 150MG,401418,CDM,637,RC,,,outpatient,,,10.13,6.58,,6.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.71,9.62,
RX PIPERACILLIN/TAZOB (ZOSYN) INJ: 4.5GM,401420,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-ABILIFY ORAL TABLET 2MG,401422,CDM,637,RC,,,outpatient,,,60.29,39.19,,40.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.14,57.28,
NF-FENOFIBRATE TAB 145MG,401423,CDM,637,RC,,,outpatient,,,21.83,14.19,,14.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.74,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.84,20.74,
NF-NEXIUM CAP DR 40MG,401425,CDM,637,RC,,,outpatient,,,26.88,17.47,,18.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.19,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.2,25.54,
NF-VANCOMYCIN HCL IV PWD FOR SOLN 500MG,401428,CDM,637,RC,,,outpatient,,,25.97,16.88,,17.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.95,24.67,
NF-CARBAMAZEPINE ORAL CAP ER 200MG,401429,CDM,637,RC,,,outpatient,,,5.36,3.48,,3.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.29,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.02,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.43,5.09,
NF-CARBAMAZEPINE ORAL TAB ER 200MG,401431,CDM,637,RC,,,outpatient,,,2.96,1.92,,1.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.66,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.81,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.79,2.81,
NF-COLCHICINE ORAL TABLET 0.6MG,401432,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-TRAVATAN OPHTH SOLN 0.004%,401433,CDM,637,RC,,,outpatient,,,98.09,63.76,,65.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.47,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.26,93.19,
NF-PROMETHAZINE (PHENERGAN) 50MG/ML INJ,401434,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
NF-VALSARTAN TAB 160MG,401435,CDM,637,RC,,,outpatient,,,13.56,8.81,,9.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.85,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.63,12.88,
NF-QUINAPRIL-HYDROCHLOROTHIAZIDE TAB 10M,401436,CDM,637,RC,,,outpatient,,,3.67,2.39,,2.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.98,3.49,
NF-LUNESTA ORAL TABLET 3MG,401439,CDM,637,RC,,,outpatient,,,13.34,8.67,,8.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.67,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.57,12.67,
NF-ABILIFY ORAL TABLET 5MG,401440,CDM,637,RC,,,outpatient,,,60.29,39.19,,40.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.14,57.28,
NF-PRED FORTE OPHTH SUSPENSION 1%,401442,CDM,637,RC,,,outpatient,,,21.44,13.94,,14.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.15,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.74,20.37,
NF-CYCLOGYL OPHTH SOLUTION 1%,401443,CDM,637,RC,,,outpatient,,,18.44,11.99,,12.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.75,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.94,17.52,
NF-LATANOPROST OPHTH SOLN 0.005%,401444,CDM,637,RC,,,outpatient,,,137.88,89.62,,92.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,124.09,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,110.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,103.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,38.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,36.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,130.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,117.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,82.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.91,130.99,
FAMOTIDINE (PEPCID) PREMX IVPB:20MG/50ML,401445,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-CORTENEMA RECTAL ENEMA 100MG/60ML,401446,CDM,637,RC,,,outpatient,,,0.62,0.4,,0.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.17,0.59,
NF-BARACLUDE ORAL TABLET 0.5MG,401447,CDM,637,RC,,,outpatient,,,98.9,64.29,,66.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.48,93.96,
INSULIN (REG)/NS IVPB:100UNITS/100ML,401448,CDM,250,RC,,,outpatient,,,57,37.05,,38.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.26,54.15,
NF-LAMOTRIGINE ORAL TABLET 200MG,401449,CDM,637,RC,,,outpatient,,,36.42,23.67,,24.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.78,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.96,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.75,34.6,
NF-CHLORPROMAZINE HCL TAB 100MG,401450,CDM,637,RC,,,outpatient,,,1.72,1.12,,1.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.46,1.63,
NF-VENLAFAXINE HCL ORAL TABLET 50MG,401451,CDM,637,RC,,,outpatient,,,6.18,4.02,,4.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.64,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.87,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.65,5.87,
NF-BUPROPION HCL TAB 75MG,401452,CDM,637,RC,,,outpatient,,,1.79,1.16,,1.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.61,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.43,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.48,1.7,
NF-BUSPIRONE HCL TAB 7.5MG,401453,CDM,637,RC,,,outpatient,,,4.74,3.08,,3.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.79,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.56,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.27,4.5,
NF-OMEPRAZOLE TAB DR 20MG,401454,CDM,637,RC,,,outpatient,,,1.82,1.18,,1.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.49,1.73,
NF-GAS-X EXTRA STRENGTH CAPSULE 125MG,401455,CDM,637,RC,,,outpatient,,,0.54,0.35,,0.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.49,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.43,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.14,0.51,
NF-MULTIVITAMIN TABLET,401456,CDM,637,RC,,,outpatient,,,0.38,0.25,,0.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.36,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.1,0.36,
NF-TRAMADOL HCL AND APAP TAB 37.5MG-325M,401457,CDM,637,RC,,,outpatient,,,3.58,2.33,,2.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.04,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.96,3.4,
NF-MIRALAX ORAL PWD FOR SOLN 17GM/1DOSE,401458,CDM,637,RC,,,outpatient,,,0.14,0.09,,0.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.11,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.11,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.04,0.13,
NF-IMODIUM A-D TABLET 2MG,401459,CDM,637,RC,,,outpatient,,,0.93,0.6,,0.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.25,0.88,
NF-IMODIUM MULTI-SYMPTOM RELIEF 2MG-125M,401460,CDM,637,RC,,,outpatient,,,1.37,0.89,,0.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.37,1.3,
MAGIC MOUTHWASH 120 ML BOTTLE,401461,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-BENAZEPRIL HCL ORAL TABLET 5MG,401462,CDM,637,RC,,,outpatient,,,3.15,2.05,,2.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.84,2.99,
NF-FLUVOXAMINE MALEATE ORAL TABLET 100MG,401463,CDM,637,RC,,,outpatient,,,7.92,5.15,,5.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.12,7.52,
LOSARTAN (COZAAR) 50 MG TABLET,401464,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
"LIDOCAINE 2% WITH EPI 1:100,000 INJ 20ML",401465,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
ESTRADIOL CYP (DEPO-ESTRADIOL) INJ: 5MG,401466,CDM,250,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
NF-TRAVATAN Z OPHTHALMIC SOLUTION 0.004%,401470,CDM,637,RC,,,outpatient,,,118.94,77.31,,79.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,107.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,95.15,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,89.21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,101.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,71.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.84,112.99,
NF-PERFOROMIST INH SOLN 20MCG/2ML,401472,CDM,637,RC,,,outpatient,,,11.09,7.21,,7.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.87,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.97,10.54,
FLUTICASONE (FLOVENT) HFA 44 MCG MDI,401473,CDM,637,RC,,,outpatient,,,305,198.25,,204.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,85.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,222.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,274.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,84.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,244,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,228.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,86.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,81.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,289.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,83.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,259.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.65,289.75,
NF-XOPENEX INH/NEB SOLN 0.31MG/3ML,401475,CDM,637,RC,,,outpatient,,,5.63,3.66,,3.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.51,5.35,
NF-FOSAMAX ORAL TABLET 10MG,401476,CDM,637,RC,,,outpatient,,,10.01,6.51,,6.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.01,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.51,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.51,
RX HEPARIN/D5W PREMIX: 25000UNITS/500ML,401478,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-NORTRIPTYLINE HCL CAP 25MG,401479,CDM,637,RC,,,outpatient,,,4.18,2.72,,2.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.12,3.97,
NF-INDAPAMIDE TAB 1.25MG,401480,CDM,637,RC,,,outpatient,,,2.04,1.33,,1.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.94,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.55,1.94,
NF-PILOCARPINE HCL OPHTH SOLN 4%,401482,CDM,637,RC,,,outpatient,,,7.98,5.19,,5.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.58,
NF-DORZOLAMIDE HCL/TIMOLOL 22.3MG-6.8MG/,401483,CDM,637,RC,,,outpatient,,,36.79,23.91,,24.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.43,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.85,34.95,
HYDROCOLLOID THIN DRESSNG (DUODERM THIN),401484,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-TRAVATAN OPHTH SOLN 0.004%,401485,CDM,637,RC,,,outpatient,,,88.86,57.76,,59.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,71.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,53.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.79,84.42,
NF-REFRESH TEARS OPHTH SOLUTION 0.5%,401486,CDM,637,RC,,,outpatient,,,1.99,1.29,,1.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.79,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.59,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.89,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.53,1.89,
NF-PREMARIN TAB 0.3MG,401487,CDM,637,RC,,,outpatient,,,3.69,2.4,,2.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.95,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.77,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.99,3.51,
NF-RAMIPRIL CAP 10MG,401488,CDM,637,RC,,,outpatient,,,6.65,4.32,,4.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.99,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.78,6.32,
NF-DORZOLAMIDE HCL-TIMOLOL 22.3MG-6.8MG/,401489,CDM,637,RC,,,outpatient,,,36.78,23.91,,24.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.94,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.85,34.94,
NF-COLCHICINE ORAL TABLET 0.6MG,401490,CDM,637,RC,,,outpatient,,,2.2,1.43,,1.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.59,2.09,
NF-NEPHRO-VITE RX TAB,401491,CDM,637,RC,,,outpatient,,,1.63,1.06,,1.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.39,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.44,1.55,
NF-HECTOROL CAP 1MCG,401492,CDM,637,RC,,,outpatient,,,55.81,36.28,,37.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.65,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.86,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.94,53.02,
NF-COLCRYS TAB 0.6MG,401493,CDM,637,RC,,,outpatient,,,17.46,11.35,,11.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.67,16.59,
KETOROLAC (TORADOL) INJ: 60MG/2ML,401495,CDM,636,RC,,,both,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-PREMARIN ORAL TABLET 0.625MG,401497,CDM,637,RC,,,outpatient,,,1.58,1.03,,1.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.42,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.42,1.5,
NF-ARTHROTEC ORAL TAB EC 75MG-0.2MG,401498,CDM,637,RC,,,outpatient,,,7.02,4.56,,4.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.88,6.67,
NF-PREMARIN ORAL TABLET 0.625MG,401499,CDM,637,RC,,,outpatient,,,9.79,6.36,,6.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.62,9.3,
NF-FELODIPINE EXTENDED-RELEASE TABLET 5M,401500,CDM,637,RC,,,outpatient,,,4.53,2.94,,3.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.21,4.3,
NF-DICLOFENAC POTASSIUM TAB 50MG,401501,CDM,637,RC,,,outpatient,,,5.6,3.64,,3.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.76,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.5,5.32,
NF-IMIPRAMINE HCL TAB 25MG,401502,CDM,637,RC,,,outpatient,,,2.15,1.4,,1.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.58,2.04,
NF-RIVASTIGMINE TARTRATE CAP 6MG,401503,CDM,637,RC,,,outpatient,,,15.54,10.1,,10.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.99,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.43,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.16,14.76,
NF-MISOPROSTOL ORAL TABLET 200MCG,401504,CDM,637,RC,,,outpatient,,,3.6,2.34,,2.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.24,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.96,3.42,
NF-BENICAR HCT ORAL TABLET 40MG-12.5MG,401505,CDM,637,RC,,,outpatient,,,14.47,9.41,,9.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.02,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.58,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.87,13.75,
NF-VESICARE ORAL TABLET 5MG,401507,CDM,637,RC,,,outpatient,,,20.49,13.32,,13.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.39,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.47,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.49,19.47,
NF-AVAPRO ORAL TABLET 150MG,401508,CDM,637,RC,,,outpatient,,,11.84,7.7,,7.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.66,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.47,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.17,11.25,
NF-SANCTURA XR CAP ER 60MG,401509,CDM,637,RC,,,outpatient,,,19.53,12.69,,13.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.23,18.55,
NF-FLUOXETINE HCL CAP 40MG,401510,CDM,637,RC,,,outpatient,,,16.01,10.41,,10.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.41,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.81,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.29,15.21,
NF-NORVASC ORAL TABLET 2.5MG,401511,CDM,637,RC,,,outpatient,,,8.34,5.42,,5.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.51,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.67,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.26,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.92,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.23,7.92,
NF-CIPROFLOXACIN  TABLET 250MG,401512,CDM,637,RC,,,outpatient,,,13.97,9.08,,9.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.57,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.74,13.27,
NF-BROVANA INH SOLN 15MCG/2ML,401513,CDM,637,RC,,,outpatient,,,12.01,7.81,,8.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.61,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.22,11.41,
NF-PULMICORT FLEXHALER INH/NEB 180MCG/1A,401514,CDM,637,RC,,,outpatient,,,529.35,344.08,,354.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,148.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,148.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,386.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,476.42,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,147.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,423.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,397.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,149.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,141.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,148.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,502.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,144.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,449.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,317.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,317.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,141.71,502.88,
NF-DORZOLAMIDE-TIMOLOL OPHTH SOLN 2%-0.5,401515,CDM,637,RC,,,outpatient,,,46.1,29.97,,30.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.49,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.34,43.8,
NF-PILOCARPINE HCL OPHTH SOLN 4%,401516,CDM,637,RC,,,outpatient,,,0.75,0.49,,0.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.56,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.64,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.2,0.71,
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.2%,401517,CDM,637,RC,,,outpatient,,,19.56,12.71,,13.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.65,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.24,18.58,
NF-CENTRUM SILVER TAB,401518,CDM,637,RC,,,outpatient,,,0.38,0.25,,0.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.36,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.1,0.36,
NF-ESTROPIPATE TABLET 0.75MG,401519,CDM,637,RC,,,outpatient,,,3.52,2.29,,2.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.64,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.94,3.34,
NF-CARBIDOPA/LEVODOPA TABLET 10MG-100MG,401520,CDM,637,RC,,,outpatient,,,3.44,2.24,,2.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.75,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.92,3.27,
MEMANTINE (NAMENDA) TABLET: 10MG,401521,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-PYRIDOSTIGMINE BROMIDE TAB 60MG,401522,CDM,637,RC,,,outpatient,,,2.39,1.55,,1.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.79,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.64,2.27,
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.25M,401523,CDM,637,RC,,,outpatient,,,1.41,0.92,,0.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.13,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.38,1.34,
SERTRALINE (ZOLOFT) TABLET: 50 MG,401524,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PROPRANOLOL (INDERAL) INJ: 1 MG/ML,401525,CDM,250,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
NF-FENOFIBRATE ORAL TABLET 160MG,401526,CDM,637,RC,,,outpatient,,,18.51,12.03,,12.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.66,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.81,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.96,17.58,
NF-OXYCODONE HCL ORAL TABLET 30MG,401529,CDM,637,RC,,,outpatient,,,5.8,3.77,,3.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.55,5.51,
NF-ADVICOR TABLET,401530,CDM,637,RC,,,outpatient,,,14.88,9.67,,9.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.9,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.98,14.14,
NF-SYNTHROID ORAL TABLET 0.112MG,401532,CDM,637,RC,,,outpatient,,,2.25,1.46,,1.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.03,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.91,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.6,2.14,
NF-SYNTHROID ORAL TABLET 0.112MG,401533,CDM,637,RC,,,outpatient,,,3.11,2.02,,2.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.64,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.83,2.95,
RX ZOLENDRONIC ACID **ZOMETA** 4MG/100ML,401534,CDM,636,RC,,,both,,,1832,1190.8,,1227.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,512.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,490.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,512.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,916,50,,,percent of total billed charges,50% of billed charges for High Cost Drugs,1648.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,510.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1465.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1374,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,518.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,490.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,512.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1740.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,500.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1557.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1099.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1099.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,500.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,490.43,1740.4,
NF-CUBICIN IV POWDER FOR SOLUTION 500MG,401535,CDM,637,RC,,,outpatient,,,973.41,632.72,,652.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,272.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,260.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,272.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,710.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,876.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,271,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,778.73,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,730.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,275.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,260.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,272.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,924.74,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,265.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,827.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,584.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,272.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,584.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,260.58,924.74,
NF-DEXAMETHASONE OPHTH SOLN 0.1%,401538,CDM,637,RC,,,outpatient,,,10.37,6.74,,6.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.33,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.78,9.85,
NF-EYETAMINS TABLET,401539,CDM,637,RC,,,outpatient,,,0.17,0.11,,0.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.05,0.16,
NF-AMILORIDE HCL ORAL TABLET 5MG,401542,CDM,637,RC,,,outpatient,,,5.5,3.58,,3.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,5.23,
NF-MESTINON TIMESPAN TABLET 180MG,401543,CDM,637,RC,,,outpatient,,,13.33,8.66,,8.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.57,12.66,
NF-MESTINON TABLET 60MG,401544,CDM,637,RC,,,outpatient,,,0.72,0.47,,0.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.58,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.19,0.68,
NF-PRADAXA CAP 150MG,401545,CDM,637,RC,,,outpatient,,,13.12,8.53,,8.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.51,12.46,
NF-BICALUTAMIDE ORAL TABLET 50MG,401547,CDM,637,RC,,,outpatient,,,49.4,32.11,,33.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.22,46.93,
PREDNISOLONE (ORAPRED) SOLN: 15 MG/5 ML,401548,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-MESTINON TABLET 60MG,401549,CDM,637,RC,,,outpatient,,,2.39,1.55,,1.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.79,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.64,2.27,
NF-MESTINON TIMESPAN TABLET 180MG,401550,CDM,637,RC,,,outpatient,,,15.33,9.96,,10.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.1,14.56,
NF-MESTINON TABLET 60MG,401551,CDM,637,RC,,,outpatient,,,2.39,1.55,,1.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.79,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.64,2.27,
NF-PROPRANOLOL HCL CAP ER 120MG,401552,CDM,637,RC,,,outpatient,,,7.22,4.69,,4.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.93,6.86,
NF-TRAZODONE HCL ORAL TABLET 100MG,401553,CDM,637,RC,,,outpatient,,,3.91,2.54,,2.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.13,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.05,3.71,
NF-MAXALT TABLET 10MG,401554,CDM,637,RC,,,outpatient,,,105.56,68.61,,70.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,84.45,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,79.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.26,100.28,
NF-EXELON TD PATCH ER 4.6MG/24HR,401555,CDM,637,RC,,,outpatient,,,30.82,20.03,,20.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.25,29.28,
NF-PROPAFENONE HYDROCHLORIDE CAP ER 325M,401556,CDM,637,RC,,,outpatient,,,24.26,15.77,,16.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.83,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.49,23.05,
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.25M,401558,CDM,637,RC,,,outpatient,,,8.85,5.75,,5.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.64,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.37,8.41,
NF-SANDIMMUNE CAPSULE 100MG,401560,CDM,637,RC,,,outpatient,,,33.02,21.46,,22.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.77,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.84,31.37,
NF-SECTRAL CAP 200MG,401561,CDM,637,RC,,,outpatient,,,9.75,6.34,,6.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.78,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.31,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.61,9.26,
NF-LIBRAX CAPSULE,401562,CDM,637,RC,,,outpatient,,,5.4,3.51,,3.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.45,5.13,
NF-ACEBUTOLOL HCL CAP 200MG,401563,CDM,637,RC,,,outpatient,,,3.02,1.96,,2.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.87,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.81,2.87,
NF-DILANTIN CAP ER 100MG,401564,CDM,637,RC,,,outpatient,,,1.17,0.76,,0.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.31,1.11,
NF-PHENOBARBITAL ORAL TABLET 60MG,401565,CDM,637,RC,,,outpatient,,,0.96,0.62,,0.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.77,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.91,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.26,0.91,
NF-PHENOBARBITAL TAB 30MG,401566,CDM,637,RC,,,outpatient,,,0.63,0.41,,0.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.57,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.17,0.6,
NF-PRADAXA CAP 150MG,401567,CDM,637,RC,,,outpatient,,,13.91,9.04,,9.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.13,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.72,13.21,
NF-PRADAXA CAP 150MG,401568,CDM,637,RC,,,outpatient,,,13.91,9.04,,9.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.13,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.72,13.21,
INSULIN LISPRO (HUMALOG) INJ:100UNITS/ML,401570,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
INSULIN LISPRO 75/25 INJ: 100 UNITS/ML,401571,CDM,250,RC,,,outpatient,,,116,75.4,,77.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,32.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,104.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,92.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,98.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,69.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.05,110.2,
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.2%,401572,CDM,637,RC,,,outpatient,,,10.88,7.07,,7.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.79,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.91,10.34,
NF-ASMANEX TWISTHALER INH PWD 0.22MG/1AC,401573,CDM,637,RC,,,outpatient,,,438.9,285.29,,294.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,122.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,122.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,320.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,395.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,122.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,351.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,329.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,124.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,117.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,122.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,119.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,373.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,263.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,263.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,117.49,416.96,
NF-LAMICTAL TAB 100MG,401574,CDM,637,RC,,,outpatient,,,5.27,3.43,,3.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.41,5.01,
NF-AMILORIDE HCL TAB 5MG,401576,CDM,637,RC,,,outpatient,,,3.87,2.52,,2.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.04,3.68,
NF-SYMBICORT INHALATION AEROSOL LIQUID,401578,CDM,637,RC,,,outpatient,,,79.79,51.86,,53.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,71.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,63.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,59.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,47.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.36,75.8,
NF-ENABLEX TAB ER 7.5MG,401579,CDM,637,RC,,,outpatient,,,17.9,11.64,,11.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.79,17.01,
NF-NORFLEX TABLET 100MG,401580,CDM,637,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
NF-PROPRANOLOL HCL TAB 80MG,401581,CDM,637,RC,,,outpatient,,,1.73,1.12,,1.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.46,1.64,
NF-XARELTO TAB 20MG,401582,CDM,637,RC,,,outpatient,,,26.24,17.06,,17.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.02,24.93,
RX MIDAZOLAM (VERSED) *5MG/ML* INJ: 50MG,401583,CDM,636,RC,,,both,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
VERSED DRIP KIT (ER),401584,CDM,636,RC,,,both,,,90,58.5,,60.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.09,85.5,
NF-LOTREL CAP 5MG-20MG,401585,CDM,637,RC,,,outpatient,,,11.94,7.76,,8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.55,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.96,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.2,11.34,
NF-PLENDIL TAB ER 5MG,401586,CDM,637,RC,,,outpatient,,,5.09,3.31,,3.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.82,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.36,4.84,
NF-MINOCYCLINE HCL CAP 100MG,401587,CDM,637,RC,,,outpatient,,,3.93,2.55,,2.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.05,3.73,
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG,401588,CDM,637,RC,,,outpatient,,,90,58.5,,60.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.09,85.5,
NF-BENICAR HCT TAB 40MG-12.5MG,401590,CDM,637,RC,,,outpatient,,,14.45,9.39,,9.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.87,13.73,
NF-LOTREL CAP 10MG-40MG,401591,CDM,637,RC,,,outpatient,,,19.71,12.81,,13.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.77,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.28,18.72,
NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,401592,CDM,637,RC,,,outpatient,,,4.36,2.83,,2.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.17,4.14,
NF-DORZOLAMIDE HCL OPHTH SOLN 2%,401594,CDM,637,RC,,,outpatient,,,19.01,12.36,,12.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.21,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.26,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.09,18.06,
NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,401595,CDM,637,RC,,,outpatient,,,9.98,6.49,,6.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.67,9.48,
NF-ASMANEX TWIST INH/NEB POWDER 220MCG/A,401596,CDM,637,RC,,,outpatient,,,554.52,360.44,,371.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,155.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,148.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,155.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,404.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,499.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,154.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,443.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,415.89,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,156.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,148.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,155.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,526.79,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,151.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,471.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,332.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,332.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,151.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,148.45,526.79,
NF-FOSAMAX ORAL TABLET 70MG,401597,CDM,637,RC,,,outpatient,,,85.69,55.7,,57.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,77.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,68.55,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,64.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,72.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,51.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.94,81.41,
NF-LUMIGAN OPHTH SOLN 0.01%,401599,CDM,637,RC,,,outpatient,,,139.6,90.74,,93.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,125.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,111.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,104.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,118.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,83.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.37,132.62,
NF-BUSPIRONE HCL TAB 10MG,401600,CDM,637,RC,,,outpatient,,,4.25,2.76,,2.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.83,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.14,4.04,
NF-TAMOXIFEN CITRATE ORAL TABLET 20MG,401601,CDM,637,RC,,,outpatient,,,11.63,7.56,,7.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.11,11.05,
NF-PROBENECID TAB 500MG,401602,CDM,637,RC,,,outpatient,,,2.95,1.92,,1.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.66,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.79,2.8,
NF-COLCRYS TAB 0.6MG,401603,CDM,637,RC,,,outpatient,,,17.46,11.35,,11.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.67,16.59,
NF-CREON CAP DR,401604,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NF-ABILIFY ORAL TABLET 5MG,401605,CDM,637,RC,,,outpatient,,,45.75,29.74,,30.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.31,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.25,43.46,
ROPINIROLE (REQUIP) TABLET: 1MG,401606,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
NF-RENAGEL TAB 800MG,401607,CDM,637,RC,,,outpatient,,,5.59,3.63,,3.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.03,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.47,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.5,5.31,
NF-SOMA TAB 350MG,401608,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-WELLBUTRIN SR 12 HR TAB ER 150MG,401610,CDM,637,RC,,,outpatient,,,9.27,6.03,,6.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.81,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.48,8.81,
NF-WELLBUTRIN SR 12 HR TAB ER 150MG,401611,CDM,637,RC,,,outpatient,,,13.2,8.58,,8.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.53,12.54,
NF-BUPROPION HCL SR ORAL 12 HR TAB ER 15,401612,CDM,637,RC,,,outpatient,,,2.35,1.53,,1.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.63,2.23,
DOPAMINE **400MG/10ML** INJECTION,401613,CDM,250,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-FLUVOXAMINE MALEATE TAB 100MG,401614,CDM,637,RC,,,outpatient,,,7.92,5.15,,5.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.12,7.52,
NF-CITALOPRAM HBR ORAL TAB 40MG,401615,CDM,637,RC,,,outpatient,,,1.02,0.66,,0.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.77,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.97,
NF-SIMVASTATIN ORAL TABLET  20MG,401616,CDM,637,RC,,,outpatient,,,0.14,0.09,,0.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.11,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.11,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.04,0.13,
NF-HYDRALAZINE HCL ORAL TABLET 50MG,401617,CDM,637,RC,,,outpatient,,,1.44,0.94,,0.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.15,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.39,1.37,
NF-OXYBUTYNIN ORAL TAB ER 10MG,401618,CDM,637,RC,,,outpatient,,,24.55,15.96,,16.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.57,23.32,
NF-METHADONE HCL ORAL TABLET 10MG,401619,CDM,637,RC,,,outpatient,,,0.45,0.29,,0.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.41,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.12,0.43,
NF-ABILITY TAB 30MG,401620,CDM,637,RC,,,outpatient,,,89.21,57.99,,59.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,80.29,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,71.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66.91,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,53.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.88,84.75,
NF-BUMETANIDE ORAL TABLET 2MG,401621,CDM,637,RC,,,outpatient,,,2.57,1.67,,1.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.31,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.69,2.44,
NF-DEXILANT CAP DR 60MG,401622,CDM,637,RC,,,outpatient,,,16.53,10.74,,11.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.43,15.7,
NF-TIKOSYN CAP 0.25MG,401623,CDM,637,RC,,,outpatient,,,14.22,9.24,,9.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.81,13.51,
NF-ADIPEX-P TABLET 37.5MG,401624,CDM,637,RC,,,outpatient,,,9.74,6.33,,6.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.79,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.31,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.61,9.25,
NF-OXYCODONE HCL ORAL TABLET 15MG,401625,CDM,637,RC,,,outpatient,,,7.29,4.74,,4.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.95,6.93,
NF-TRAVATAN Z OPHTH SOLN 0.004%,401627,CDM,637,RC,,,outpatient,,,128.48,83.51,,86.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,115.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,35.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,102.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,96.36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,122.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,109.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,77.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.39,122.06,
NF-CASODEX TABLET 50MG,401628,CDM,637,RC,,,outpatient,,,68.23,44.35,,45.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.41,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.58,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.27,64.82,
NF-FLORASTOR CAPSULE 250MG,401629,CDM,637,RC,,,outpatient,,,3.2,2.08,,2.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.72,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.86,3.04,
NF-FENOFIBRATE ORAL TABLET 160MG,401630,CDM,637,RC,,,outpatient,,,7.13,4.63,,4.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.42,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.91,6.77,
NF-NORTRIPTYLINE HCL CAP 50MG,401631,CDM,637,RC,,,outpatient,,,7.5,4.88,,5.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.01,7.13,
NF-ALLEGRA TAB 180MG,401632,CDM,637,RC,,,outpatient,,,8.5,5.53,,5.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.28,8.08,
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.2%,401633,CDM,637,RC,,,outpatient,,,19.58,12.73,,13.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.64,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.24,18.6,
NF-LATANOPROST OPHTH SOLN 0.005%,401634,CDM,637,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
NF-EDURANT TAB 25MG,401635,CDM,637,RC,,,outpatient,,,80.44,52.29,,53.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64.35,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.53,76.42,
NF-NORVIR ORAL TABLET 100MG,401636,CDM,637,RC,,,outpatient,,,30.86,20.06,,20.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.69,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.26,29.32,
NF-EMTRIVA CAP 200MG,401637,CDM,637,RC,,,outpatient,,,81.86,53.21,,54.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,73.67,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,65.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,61.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,69.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.91,77.77,
NF-PREZISTA TAB 400MG,401638,CDM,637,RC,,,outpatient,,,79.96,51.97,,53.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,71.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,63.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,59.97,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,47.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.41,75.96,
NF-SULINDAC ORAL TABLET 200MG,401639,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
NF-WELCHOL ORAL TABLET 625MG,401640,CDM,637,RC,,,outpatient,,,4.82,3.13,,3.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.62,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.29,4.58,
NF-DORZOLAMIDE HCL OPHTH SOLN 2%,401641,CDM,637,RC,,,outpatient,,,20.22,13.14,,13.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.41,19.21,
NF-DORZOLAMIDE HCL OPHTH SOLN 2%,401642,CDM,637,RC,,,outpatient,,,17.1,11.12,,11.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.58,16.25,
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.2%,401643,CDM,637,RC,,,outpatient,,,10.22,6.64,,6.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.74,9.71,
PEG KIT,401645,CDM,270,RC,,,outpatient,,,148.2,96.33,,99.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,41.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,133.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,41.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,118.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,111.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.79,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,40.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,125.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,88.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.67,140.79,
RX METHYLPREDNISOLONE SOD SUC 1GM infus,401646,CDM,636,RC,,,both,,,85,55.25,,56.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,76.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,72.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.75,80.75,
NF-TEMOVATE TOPICAL CREAM 0.05%,401648,CDM,637,RC,,,outpatient,,,6.24,4.06,,4.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.67,5.93,
PANCREATIC ENZYMES CAPSULES,401649,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-DORZOLAMIDE HYDROCHLORIDE-TIMOLOL MAL,401651,CDM,637,RC,,,outpatient,,,20.25,13.16,,13.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.42,19.24,
NF-BUDESONIDE INHALATION SUSP 0.5MG/2ML,401652,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-CULTURELLE ORAL CAPSULE 10 BILLION OR,401653,CDM,637,RC,,,outpatient,,,1.34,0.87,,0.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.36,1.27,
NF-WELLBUTRIN SR 12 HR TAB ER 100MG,401654,CDM,637,RC,,,outpatient,,,12.32,8.01,,8.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.09,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.3,11.7,
NF-FENOFIBRATE ORAL TABLET 160MG,401655,CDM,637,RC,,,outpatient,,,18.51,12.03,,12.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.66,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.81,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.96,17.58,
NF-FENOFIBRATE ORAL TABLET 160MG,401656,CDM,637,RC,,,outpatient,,,18.51,12.03,,12.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.66,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.81,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.96,17.58,
NF-JANUMET ORAL TABLET 50MG-1000MG,401657,CDM,637,RC,,,outpatient,,,13.43,8.73,,9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.09,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.6,12.76,
NF-PREMARIN ORAL TABLET 0.3MG,401658,CDM,637,RC,,,outpatient,,,8.54,5.55,,5.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.29,8.11,
NF-PREMARIN ORAL TABLET 0.3MG,401659,CDM,637,RC,,,outpatient,,,8.54,5.55,,5.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.29,8.11,
NF-BUPROPION SR ORAL 12HR TAB ER 100MG,401660,CDM,637,RC,,,outpatient,,,8.47,5.51,,5.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.27,8.05,
NF-ALENDRONATE SODIUM ORAL TABLET 5MG,401662,CDM,637,RC,,,outpatient,,,8.78,5.71,,5.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.35,8.34,
NF-SENSIPAR TAB 30MG,401663,CDM,637,RC,,,outpatient,,,36.81,23.93,,24.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.45,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.85,34.97,
NF-MULTAQ TAB 400MG,401664,CDM,637,RC,,,outpatient,,,15.7,10.21,,10.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.92,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.2,14.92,
NF-LUMIGAN OPHTH SOLN 0.01%,401665,CDM,637,RC,,,outpatient,,,139.6,90.74,,93.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,125.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,111.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,104.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,118.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,83.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.37,132.62,
RX LEVETIRACETAM (KEPPRA) INJ: 500MG,401666,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-EFFIENT ORAL TABLET 10MG,401668,CDM,637,RC,,,outpatient,,,24.83,16.14,,16.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.62,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.65,23.59,
NF-ERYTHROMYCIN BASE ORAL TABLET 250MG,401669,CDM,637,RC,,,outpatient,,,1.63,1.06,,1.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.39,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.44,1.55,
NF-ALLEGRA ALLERGY TAB 180MG,401670,CDM,637,RC,,,outpatient,,,1.87,1.22,,1.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.5,1.78,
NF-INSPRA TAB 25MG,401671,CDM,637,RC,,,outpatient,,,17.76,11.54,,11.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.21,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.87,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.75,16.87,
NF-ATENOLOL/CHLORTHALIDONE TABLET 50MG-2,401672,CDM,637,RC,,,outpatient,,,2.92,1.9,,1.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.78,2.77,
NF-FOLIC ACID ORAL TABLET 0.8MG,401673,CDM,637,RC,,,outpatient,,,0.05,0.03,,0.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.04,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.01,0.05,
LEVETIRACETAM (KEPPRA) TABLET:  500MG,401674,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-BUDESONIDE INH/NEB SUSP 0.25MG/2ML,401676,CDM,637,RC,,,outpatient,,,12.96,8.42,,8.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.66,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.47,12.31,
NF-METHOTREXATE ORAL TABLET 2.5MG,401677,CDM,637,RC,,,outpatient,,,3.28,2.13,,2.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.46,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.88,3.12,
NF-METHOTREXATE ORAL TABLET 2.5MG,401678,CDM,637,RC,,,outpatient,,,10.96,7.12,,7.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.77,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.93,10.41,
NF-LANTUS SOLOSTAR SUBQ SOLN 100U/1ML,401679,CDM,637,RC,,,outpatient,,,54.78,35.61,,36.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.09,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.66,52.04,
NF-PYRIDOSTIGMINE BROMIDE TAB 60MG,401680,CDM,637,RC,,,outpatient,,,1.8,1.17,,1.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.48,1.71,
D10W 250 ML,401681,CDM,258,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG,401682,CDM,637,RC,,,outpatient,,,76.97,50.03,,51.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,69.27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,61.58,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,57.73,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,46.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.6,73.12,
NF-LEVOTHYROXINE SODIUM LIQ CAP 137MCG,401683,CDM,637,RC,,,outpatient,,,3.43,2.23,,2.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.09,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.92,3.26,
NF-LYSODREN TAB 500MG,401684,CDM,637,RC,,,outpatient,,,15.38,10,,10.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.12,14.61,
NF-MECLIZINE HCL ORAL TABLET 12.5MG,401685,CDM,637,RC,,,outpatient,,,1.17,0.76,,0.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.31,1.11,
NF-SAPHRIS SL TAB 10MG,401688,CDM,637,RC,,,outpatient,,,37.65,24.47,,25.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.08,35.77,
NF-BUSPIRONE HCL TAB 10MG,401689,CDM,637,RC,,,outpatient,,,3.75,2.44,,2.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1,3.56,
NF-ADCIRCA TAB 20MG,401690,CDM,637,RC,,,outpatient,,,87.23,56.7,,58.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.51,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.87,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.35,82.87,
NF-RIFAXIMIN TAB 550MG,401691,CDM,637,RC,,,outpatient,,,74.1,48.17,,49.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,66.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,59.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.84,70.4,
NF-ASMANEX TWISTHALER INH PWD 0.22MG/1AC,401692,CDM,637,RC,,,outpatient,,,804.93,523.2,,539.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,225.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,215.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,225.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,587.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,724.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,224.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,643.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,603.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,227.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,215.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,225.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,764.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,219.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,684.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,482.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,482.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,215.48,764.68,
NF-COREG CR CAP ER 40MG,401693,CDM,637,RC,,,outpatient,,,16.24,10.56,,10.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.35,15.43,
NF-WELCHOL TAB 625MG,401694,CDM,637,RC,,,outpatient,,,7.46,4.85,,5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2,7.09,
NF-MAGNESIUM OXIDE TABLET 250MG,401695,CDM,637,RC,,,outpatient,,,0.06,0.04,,0.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.05,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.06,
CASTOR OIL 60 ML,401697,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-BICALUTAMIDE ORAL TABLET 50MG,401698,CDM,637,RC,,,outpatient,,,55.62,36.15,,37.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.89,52.84,
NF-LAMOTRIGINE (LAMICTAL) TABLET: 25 MG,401699,CDM,250,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
NF-OMEPRAZOLE CAP DR 40MG,401700,CDM,637,RC,,,outpatient,,,22.19,14.42,,14.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.75,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.64,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.94,21.08,
NF-OXYCODONE/APAP ORAL TABLET 7.5MG-325M,401701,CDM,637,RC,,,outpatient,,,5.5,3.58,,3.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,5.23,
NF-LAMOTRIGINE ORAL TABLET 200MG,401703,CDM,637,RC,,,outpatient,,,17.01,11.06,,11.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.31,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.61,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.16,
NF-KETOROLAC TROMETHAMINE OPHTH SOLN 0.4,401704,CDM,637,RC,,,outpatient,,,94.43,61.38,,63.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,84.99,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,75.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,70.82,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.28,89.71,
NF-BICALUTAMIDE ORAL TABLET 50MG,401707,CDM,637,RC,,,outpatient,,,55.68,36.19,,37.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.91,52.9,
NF-METHADONE HCL ORAL TABLET 10MG,401709,CDM,637,RC,,,outpatient,,,0.45,0.29,,0.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.41,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.12,0.43,
CHLORTHALIDONE (HYGROTON) TABLET: 25 MG,401712,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PYRIDOSTIGMINE (MESTINON) TABLET: 60 MG,401713,CDM,250,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
ENALAPRIL (VASOTEC) TABLET:  5 MG,401714,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-XTANDI LIQ CAP 40MG,401715,CDM,637,RC,,,outpatient,,,223.5,145.28,,149.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,201.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,178.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,167.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,59.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,212.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,189.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,59.83,212.33,
NF-CALTRATE 600+D ORAL TABLET 600MG-200I,401716,CDM,637,RC,,,outpatient,,,0.33,0.21,,0.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.09,0.31,
NF-EVISTA ORAL TABLET 60MG,401718,CDM,637,RC,,,outpatient,,,19.16,12.45,,12.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.24,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.33,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.13,18.2,
NF-QUALAQUIN CAP 324MG,401719,CDM,637,RC,,,outpatient,,,23.57,15.32,,15.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.39,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.31,22.39,
NF-ROPINIROLE HCL TAB 0.5MG,401720,CDM,637,RC,,,outpatient,,,10.71,6.96,,7.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.57,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.87,10.17,
NF-HYDROCORTISONE ORAL TABLET 20MG,401721,CDM,637,RC,,,outpatient,,,1.55,1.01,,1.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.41,1.47,
NF-HYDROCORTISONE TABLET 20MG,401722,CDM,637,RC,,,outpatient,,,1.4,0.91,,0.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.37,1.33,
NITROGLYCERIN PREMIX BOTTLE: 25MG/250ML,401725,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,401726,CDM,637,RC,,,outpatient,,,10.52,6.84,,7.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.89,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.94,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.82,9.99,
NF-B-COMPLEX W/VITAMIN C CAPSULE,401727,CDM,637,RC,,,outpatient,,,0.1,0.07,,0.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.09,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.03,0.1,
NF-OXYCODONE HCL ORAL TABLET 30MG,401728,CDM,637,RC,,,outpatient,,,7.79,5.06,,5.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.09,7.4,
NF-TOPIRAMATE ORAL TABLET 100MG,401729,CDM,637,RC,,,outpatient,,,20.31,13.2,,13.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.25,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.44,19.29,
LOSARTAN/HCTZ (HYZAAR) 100/25 MG TABLET,401731,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-VITAMIN D3 LIQUID-FILLED CAPSULE 2000,401732,CDM,637,RC,,,outpatient,,,0.4,0.26,,0.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.11,0.38,
NF-HCTZ/TRIAMTERENE CAPSULE,401733,CDM,637,RC,,,outpatient,,,1.08,0.7,,0.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.29,1.03,
NF-RANEXA EXTENDED-RELEASE TABLET 500MG,401734,CDM,637,RC,,,outpatient,,,13.58,8.83,,9.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.64,12.9,
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.125,401735,CDM,637,RC,,,outpatient,,,8.85,5.75,,5.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.64,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.37,8.41,
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.125,401736,CDM,637,RC,,,outpatient,,,6.22,4.04,,4.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.91,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.67,5.91,
NF-VITAMIN D3 LIQUID-FILLED CAPSULE 2000,401737,CDM,637,RC,,,outpatient,,,0.17,0.11,,0.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.05,0.16,
ADENOSINE 6 MG/2ML INJECTION *VIAL*,401738,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
NF-SYSTANE LUBRICANT EYE DROPS 0.4%-0.3%,401739,CDM,637,RC,,,outpatient,,,5.21,3.39,,3.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.91,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.39,4.95,
NF-NORVIR CAPSULE 100MG,401740,CDM,637,RC,,,outpatient,,,38.18,24.82,,25.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.64,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.22,36.27,
NF-PREZISTA ORAL TABLET 600MG,401741,CDM,637,RC,,,outpatient,,,61.51,39.98,,41.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.21,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.47,58.43,
NF-VIREAD ORAL TABLET 300MG,401742,CDM,637,RC,,,outpatient,,,94.23,61.25,,63.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,84.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,75.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,70.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,56.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.23,89.52,
NF-SELZENTRY ORAL TABLET 150MG,401743,CDM,637,RC,,,outpatient,,,104.96,68.22,,70.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,94.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,83.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,78.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,62.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.1,99.71,
KCL MINIBAG 10 MEQ/100 ML,401744,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-XOPENEX INH/NEB SOLN 1.25MG/0.5ML,401745,CDM,637,RC,,,outpatient,,,22.36,14.53,,14.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.89,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.77,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.99,21.24,
NF-IPRATROPIUM BROMIDE INH SOLN 0.02%,401746,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-MUCINEX FAST-MAX ORAL SOLUTION,401747,CDM,637,RC,,,outpatient,,,0.16,0.1,,0.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.13,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.04,0.15,
NF-COLCRYS ORAL TABLET 0.6MG,401748,CDM,637,RC,,,outpatient,,,20.86,13.56,,13.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.69,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.58,19.82,
NF-IMIPRAMINE HCL TAB 25MG,401749,CDM,637,RC,,,outpatient,,,2.29,1.49,,1.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.61,2.18,
NF-NAPROXEN EC ORAL TAB EC 375MG,401750,CDM,637,RC,,,outpatient,,,4.8,3.12,,3.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.28,4.56,
NF-ATORVASTATIN CALCIUM ORAL TAB 80MG,401751,CDM,637,RC,,,outpatient,,,16.48,10.71,,11.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.83,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.41,15.66,
NF-HYDROCODONE BITART/ACET TAB 10MG-650M,401752,CDM,637,RC,,,outpatient,,,1.58,1.03,,1.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.42,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.42,1.5,
NF-CYMBALTA CAP DR 60MG,401753,CDM,637,RC,,,outpatient,,,20.06,13.04,,13.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.05,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.37,19.06,
NF-VOLTAREN GEL 1%,401754,CDM,637,RC,,,outpatient,,,1.48,0.96,,0.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.33,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.11,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.4,1.41,
NF-NORVASC ORAL TABLET 2.5MG,401755,CDM,637,RC,,,outpatient,,,7.01,4.56,,4.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.31,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.61,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.26,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.96,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.88,6.66,
NF-DIOVAN HCT ORAL TABLET 12.5MG-160MG,401757,CDM,637,RC,,,outpatient,,,15.73,10.22,,10.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.58,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.94,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.21,14.94,
NF-DIOVAN TAB 160MG,401758,CDM,637,RC,,,outpatient,,,14.45,9.39,,9.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.87,13.73,
NF-PROPAFENONE HCL TAB 150MG,401759,CDM,637,RC,,,outpatient,,,4.27,2.78,,2.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.14,4.06,
NF-DIOVAN ORAL TABLET 160MG,401760,CDM,637,RC,,,outpatient,,,9.14,5.94,,6.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.31,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.86,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.45,8.68,
ATROPINE INJECTION SDV: 1 MG/ML,401761,CDM,250,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
NF-IPRATROPIUM BROMIDE INH/NEB SOLN 0.02,401762,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,401763,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-VIIBRYD TITRATION PACK TAB 10MG;20MG;,401764,CDM,637,RC,,,outpatient,,,16.59,10.78,,11.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.93,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.27,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.44,15.76,
NF-IPRATROPIUM BROMIDE INH SOLN 0.02%,401765,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-MEPITEL DRESSING,401766,CDM,637,RC,,,outpatient,,,21.72,14.12,,14.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.81,20.63,
NF-SECTRAL CAP 400MG,401767,CDM,637,RC,,,outpatient,,,12.97,8.43,,8.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.67,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.73,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.47,12.32,
NF-LANSOPRAZOLE CAP DR 15MG,401768,CDM,637,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
NF-LANSOPRAZOLE CAP DR 30MG,401770,CDM,637,RC,,,outpatient,,,18.97,12.33,,12.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.08,18.02,
NF-ELIQUIS TAB 5MG,401771,CDM,637,RC,,,outpatient,,,15.02,9.76,,10.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.27,
NF-FEXOFENADINE HCL ORAL TABLET 60MG,401772,CDM,637,RC,,,outpatient,,,5.66,3.68,,3.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.09,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.53,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.52,5.38,
NF-IMIPRAMINE HCL TAB 25MG,401773,CDM,637,RC,,,outpatient,,,2.62,1.7,,1.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.97,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.7,2.49,
NF-LEVOTHYROXINE ORAL TABLET 0.112MG,401775,CDM,637,RC,,,outpatient,,,3.53,2.29,,2.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.94,3.35,
NF-ATENOLOL ORAL TABLET 25MG,401776,CDM,637,RC,,,outpatient,,,2.45,1.59,,1.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.66,2.33,
NF-RIFAXIMIN TAB 550MG,401777,CDM,637,RC,,,outpatient,,,88.17,57.31,,59.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.94,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.6,83.76,
NF-TORADOL TABLET 10MG,401778,CDM,637,RC,,,outpatient,,,6.04,3.93,,4.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.74,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.62,5.74,
NF-XARELTO ORAL TABLET 10MG,401779,CDM,637,RC,,,outpatient,,,30.04,19.53,,20.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.04,28.54,
NF-XARELTO TAB 20MG,401780,CDM,637,RC,,,outpatient,,,30.04,19.53,,20.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.04,28.54,
NF-COMBIGAN OPHTH SOLN 0.2%-0.5%,401781,CDM,637,RC,,,outpatient,,,67.51,43.88,,45.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,60.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.01,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,50.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.07,64.13,
NF-AMITIZA LIQ CAP 8MCG,401782,CDM,637,RC,,,outpatient,,,12.89,8.38,,8.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.31,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.96,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.45,12.25,
NF-OMEPRAZOLE CAP DR 40MG,401783,CDM,637,RC,,,outpatient,,,17.82,11.58,,11.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.77,16.93,
NF-MIRTAZAPINE ORAL TABLET 15MG,401784,CDM,637,RC,,,outpatient,,,7.78,5.06,,5.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.39,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.08,7.39,
COLCHICINE (COLYCRYS) TABLET: 0.6 MG,401785,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
LEVOTHYROXINE (SYNTHROID) TABLET: 25MCG,401786,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-MAGNESIUM OXIDE TABLET 500MG,401787,CDM,637,RC,,,outpatient,,,0.13,0.08,,0.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.03,0.12,
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.125,401788,CDM,637,RC,,,outpatient,,,8.84,5.75,,5.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.37,8.4,
NF-XARELTO TAB 20MG,401789,CDM,637,RC,,,outpatient,,,30.04,19.53,,20.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.04,28.54,
CEFOTETAN INJECTION: 1 GM *nf*,401792,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-LAMIVUDINE AND ZIDOVUDINE ORAL TABLET,401793,CDM,637,RC,,,outpatient,,,46.58,30.28,,31.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,37.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.47,44.25,
NF-VITAMIN B6 TABLET 50MG,401794,CDM,637,RC,,,outpatient,,,0.06,0.04,,0.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.05,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.06,
NF-CITRACAL ULTRADENSE CAL CITR 200IU-31,401795,CDM,637,RC,,,outpatient,,,0.21,0.14,,0.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.19,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,0.2,
NF-VITAMIN E CAPSULE 400IU,401796,CDM,637,RC,,,outpatient,,,0.18,0.12,,0.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.05,0.17,
NF-TRIMETHOPRIM TAB 100MG,401797,CDM,637,RC,,,outpatient,,,2.05,1.33,,1.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.55,1.95,
NF-AMPYRA TAB ER 10MG,401798,CDM,637,RC,,,outpatient,,,86.76,56.39,,58.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.23,82.42,
NF-LYRICA CAP 200MG,401799,CDM,637,RC,,,outpatient,,,12.05,7.83,,8.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.23,11.45,
NF-NORVIR TAB 100MG,401800,CDM,637,RC,,,outpatient,,,38.57,25.07,,25.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.33,36.64,
NF-VIREAD TAB 300MG,401801,CDM,637,RC,,,outpatient,,,109.16,70.95,,73.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,98.24,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,87.33,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,81.87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,92.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,65.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.22,103.7,
NF-SELZENTRY TAB 150MG,401802,CDM,637,RC,,,outpatient,,,84.35,54.83,,56.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,67.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63.26,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.58,80.13,
NF-PREZISTA TAB 600MG,401803,CDM,637,RC,,,outpatient,,,76.89,49.98,,51.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,69.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,61.51,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,57.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,46.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.58,73.05,
NF-TORSEMIDE ORAL TABLET 20MG,401805,CDM,637,RC,,,outpatient,,,2.46,1.6,,1.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.66,2.34,
NF-ABILIFY ORAL TABLET 2MG,401806,CDM,637,RC,,,outpatient,,,55.04,35.78,,36.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.28,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.73,52.29,
NF-ELIQUIS TAB 5MG,401808,CDM,637,RC,,,outpatient,,,15.02,9.76,,10.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.27,
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.125,401809,CDM,637,RC,,,outpatient,,,6.32,4.11,,4.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.74,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.69,6,
NF-BUSPIRONE HCL TAB 5MG,401810,CDM,637,RC,,,outpatient,,,0.18,0.12,,0.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.05,0.17,
NF-PERFOROMIST INH SOLN 20MCG/2ML,401811,CDM,637,RC,,,outpatient,,,14.17,9.21,,9.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.04,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.79,13.46,
NF-IPRATROPIUM BROMIDE INH/NEB SOLN 0.02,401812,CDM,637,RC,,,outpatient,,,2.68,1.74,,1.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.41,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.72,2.55,
NF-IPRATROPIUM BROMIDE INH/NEB SOLN 0.02,401813,CDM,637,RC,,,outpatient,,,0.24,0.16,,0.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.19,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,0.23,
NF-PINDOLOL TAB 5MG,401814,CDM,637,RC,,,outpatient,,,3.11,2.02,,2.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.64,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.83,2.95,
NF-BIAXIN FILMTAB TAB 500MG,401816,CDM,637,RC,,,outpatient,,,25.74,16.73,,17.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.59,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.31,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.89,24.45,
NF-MYCOBUTIN CAP 150MG,401817,CDM,637,RC,,,outpatient,,,70.85,46.05,,47.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,63.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,56.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,53.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,42.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.97,67.31,
NF-ESTRACE ORAL TABLET 0.5MG,401818,CDM,637,RC,,,outpatient,,,1.44,0.94,,0.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.15,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.39,1.37,
DOPAMINE *PREMIX* IN D5W: 400MG/500ML,401819,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-XIFAXAN TAB 550MG,401821,CDM,637,RC,,,outpatient,,,80.43,52.28,,53.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.53,76.41,
NF-ACCUPRIL ORAL TABLET 10MG,401822,CDM,637,RC,,,outpatient,,,5.94,3.86,,3.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.75,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.46,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.59,5.64,
NF-LOTENSIN TAB 5MG,401823,CDM,637,RC,,,outpatient,,,3.37,2.19,,2.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.03,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.9,3.2,
NF-QUINAPRIL HCL TAB 10MG,401825,CDM,637,RC,,,outpatient,,,8.32,5.41,,5.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.49,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.23,7.9,
NF-COPAXONE SUBQ KIT 20MG/1ML,401826,CDM,637,RC,,,outpatient,,,6792.78,4415.31,,4551.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1901.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1818.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1901.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4958.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6113.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1891.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5434.22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5094.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1921,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1818.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1901.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6453.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1854.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5773.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4075.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1901.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4075.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1854.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1818.43,6453.14,
NF-ESTROPIPATE TAB 0.75MG,401827,CDM,637,RC,,,outpatient,,,1.41,0.92,,0.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.13,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.38,1.34,
NF-PREMPRO ORAL TABLET 0.625MG-5MG,401828,CDM,637,RC,,,outpatient,,,5.75,3.74,,3.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.31,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.54,5.46,
NF-PRADAXA CAP 75MG,401830,CDM,637,RC,,,outpatient,,,13.12,8.53,,8.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.51,12.46,
NF-FEXOFENADINE HCL ORAL TABLET 180MG,401831,CDM,637,RC,,,outpatient,,,19.6,12.74,,13.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.25,18.62,
NF-FEXOFENADINE HCL ORAL TABLET 180MG,401833,CDM,637,RC,,,outpatient,,,2.15,1.4,,1.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.58,2.04,
NF-PRADAXA CAP 75MG,401834,CDM,637,RC,,,outpatient,,,13.12,8.53,,8.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.51,12.46,
NF-DIOVAN HCT ORAL TABLET 12.5MG-160MG,401835,CDM,637,RC,,,outpatient,,,20.31,13.2,,13.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.25,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.44,19.29,
NF-FLECAINIDE ACETATE ORAL TABLET 50MG,401836,CDM,637,RC,,,outpatient,,,5.1,3.32,,3.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.37,4.85,
NF-PAMELOR CAPSULE 50MG,401840,CDM,637,RC,,,outpatient,,,83.96,54.57,,56.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,67.17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.97,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.48,79.76,
NF-ISENTRESS ORAL TABLET 400MG,401841,CDM,637,RC,,,outpatient,,,64.44,41.89,,43.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.55,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.22,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.25,61.22,
NF-TRUVADA ORAL TABLET 200MG-300MG,401842,CDM,637,RC,,,outpatient,,,190.84,124.05,,127.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,53.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,139.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,171.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,53.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,152.67,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,143.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,53.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,51.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,52.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,162.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,114.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.09,181.3,
NF-ARMOUR THYROID TABLET 120MG,401843,CDM,637,RC,,,outpatient,,,1.16,0.75,,0.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.93,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.31,1.1,
NF-SENSIPAR TAB 60MG,401844,CDM,637,RC,,,outpatient,,,111.82,72.68,,74.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,100.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,89.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,83.87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.93,106.23,
NF-LUMIGAN OPHTH SOLN 0.01%,401845,CDM,637,RC,,,outpatient,,,150.83,98.04,,101.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,135.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,120.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,113.12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,42.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,143.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,128.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,90.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.38,143.29,
NF-LORAZEPAM INTENSOL CONCENTRATE 2MG/ML,401846,CDM,637,RC,,,outpatient,,,4.8,3.12,,3.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.28,4.56,
NF-ADVAIR DISKUS 500/50 DISK,401847,CDM,637,RC,,,outpatient,,,18.77,12.2,,12.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.02,17.83,
NF-NITROFURANTOIN CAP 100MG,401848,CDM,637,RC,,,outpatient,,,11.76,7.64,,7.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.82,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.15,11.17,
NF-BYSTOLIC ORAL TABLET 10MG,401850,CDM,637,RC,,,outpatient,,,8.71,5.66,,5.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.33,8.27,
NF-ZAFIRLUKAST TAB 20MG,401851,CDM,637,RC,,,outpatient,,,6.83,4.44,,4.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.83,6.49,
NF-LOXAPINE CAPSULE 25MG,401853,CDM,637,RC,,,outpatient,,,5.77,3.75,,3.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.19,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.54,5.48,
NF-ARICEPT ORAL TABLET 23MG,401854,CDM,637,RC,,,outpatient,,,37.86,24.61,,25.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.29,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.14,35.97,
NF-HYDROXYZINE HCL ORAL TABLET 10MG,401855,CDM,637,RC,,,outpatient,,,1.87,1.22,,1.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.5,1.78,
NF-DIOVAN HCT ORAL TABLET 12.5MG-80MG,401856,CDM,637,RC,,,outpatient,,,10.83,7.04,,7.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.9,10.29,
NF-BIAXIN FILMTAB TAB 500MG,401858,CDM,637,RC,,,outpatient,,,16.09,10.46,,10.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.87,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.31,15.29,
NF-DIOVAN HCT ORAL TABLET 12.5MG-80MG,401859,CDM,637,RC,,,outpatient,,,14.46,9.4,,9.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.57,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.74,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.87,13.74,
NF-LETROZOLE TAB 2.5MG,401860,CDM,637,RC,,,outpatient,,,54.4,35.36,,36.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.56,51.68,
NF-TRAVATAN Z OPHTH SOLN 0.004%,401861,CDM,637,RC,,,outpatient,,,138.74,90.18,,92.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,124.87,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,110.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,104.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,117.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,83.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.14,131.8,
NF-PREMARIN ORAL TABLET 0.625MG,401862,CDM,637,RC,,,outpatient,,,13.3,8.65,,8.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.98,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.56,12.64,
NF-PREMARIN ORAL TABLET 0.625MG,401864,CDM,637,RC,,,outpatient,,,13.3,8.65,,8.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.98,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.56,12.64,
NF-PREMARIN ORAL TABLET 0.625MG,401866,CDM,637,RC,,,outpatient,,,10.23,6.65,,6.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.74,9.72,
NF-ACETAZOLAMIDE ORAL TABLET 250MG,401867,CDM,637,RC,,,outpatient,,,13.29,8.64,,8.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.97,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.56,12.63,
"NF-BUTRANS 20MCG/HR TRANSDERMAL PATCH, E",401868,CDM,637,RC,,,outpatient,,,351.14,228.24,,235.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,98.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,256.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,316.03,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,97.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,280.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,263.36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,99.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,333.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,95.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,298.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,210.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,98.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,94,333.58,
NF-ZYTIGA TAB 250MG,401869,CDM,637,RC,,,outpatient,,,191.86,124.71,,128.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,53.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,172.67,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,53.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,153.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,143.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,54.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,51.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,182.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,52.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,115.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.36,182.27,
NF-BYETTA SUBCUTANEOUS SOLUTION 250MCG/1,401870,CDM,637,RC,,,outpatient,,,791.9,514.74,,530.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,221.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,211.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,221.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,578.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,712.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,220.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,633.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,593.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,223.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,211.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,221.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,752.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,216.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,673.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,475.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,475.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,211.99,752.31,
NF-LOTENSIN HCT 20MG-12.5MG ORAL TABLET,401871,CDM,637,RC,,,outpatient,,,4.67,3.04,,3.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.25,4.44,
NF-FEMARA 2.5MG ORAL TABLET,401872,CDM,637,RC,,,outpatient,,,66.43,43.18,,44.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.79,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.82,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.78,63.11,
NF-TOPAMAX ORAL TABLET 50MG,401873,CDM,637,RC,,,outpatient,,,15.8,10.27,,10.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.23,15.01,
NF-TOPIRAMATE ORAL TABLET 50MG,401874,CDM,637,RC,,,outpatient,,,12.45,8.09,,8.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.33,11.83,
NF-METHOTREXATE ORAL TABLET 2.5MG,401875,CDM,637,RC,,,outpatient,,,21.38,13.9,,14.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.24,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.72,20.31,
MIRTAZEPINE (REMERON) TABLET: 15 MG,401876,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-ANASTROZOLE ORAL TABLET 1MG,401877,CDM,637,RC,,,outpatient,,,40.49,26.32,,27.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.39,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.47,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.84,38.47,
NF-FENOFIBRATE ORAL TABLET 145MG,401878,CDM,637,RC,,,outpatient,,,17.19,11.17,,11.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.75,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.89,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.6,16.33,
NF-MEPERIDINE HCL TAB 50MG,401879,CDM,637,RC,,,outpatient,,,2.04,1.33,,1.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.94,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.55,1.94,
NF-BYSTOLIC ORAL TABLET 5MG,401880,CDM,637,RC,,,outpatient,,,8.71,5.66,,5.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.33,8.27,
NF-SULFAMYLON 50GM/PACKET,401881,CDM,637,RC,,,outpatient,,,535.99,348.39,,359.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,150.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,143.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,150.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,391.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,482.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,149.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,428.79,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,401.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,151.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,143.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,150.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,509.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,146.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,455.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,321.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,321.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,146.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,143.48,509.19,
NF-EVISTA 60MG ORAL TABLET,401883,CDM,637,RC,,,outpatient,,,21.62,14.05,,14.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.79,20.54,
NF-OCELLA TAB 3MG-0.03MG-NO STRENGTH,401884,CDM,637,RC,,,outpatient,,,8.22,5.34,,5.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.58,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.81,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.2,7.81,
NF-ACETAZOLAMIDE ORAL TABLET 250MG,401885,CDM,637,RC,,,outpatient,,,13.29,8.64,,8.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.97,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.56,12.63,
NF-VIIBRYD TAB 40MG,401886,CDM,637,RC,,,outpatient,,,16.59,10.78,,11.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.93,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.27,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.44,15.76,
NF-ORACEA CAP ER 40MG,401887,CDM,637,RC,,,outpatient,,,52.2,33.93,,34.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.97,49.59,
NF-DONEPEZIL HCL TAB 10MG,401888,CDM,637,RC,,,outpatient,,,25.99,16.89,,17.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.79,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.69,
NF-METHOTREXATE 2.5MG ORAL TABLET,401889,CDM,637,RC,,,outpatient,,,10.35,6.73,,6.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.77,9.83,
NF-ARIMIDEX TAB 1MG,401890,CDM,637,RC,,,outpatient,,,52.08,33.85,,34.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.87,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.94,49.48,
NF-LATANOPROST OPHTH SOLN 0.005%,401891,CDM,637,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.2%,401892,CDM,637,RC,,,outpatient,,,19.55,12.71,,13.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.23,18.57,
NF-WELLBUTRIN ORAL TABLET 100MG,401893,CDM,637,RC,,,outpatient,,,5.58,3.63,,3.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.02,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.74,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.49,5.3,
NF-VIAGRA ORAL TABLET 50MG,401894,CDM,637,RC,,,outpatient,,,55.16,35.85,,36.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.13,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.77,52.4,
NF-METHYLPHENIDATE HCL ORAL TAB ER 36MG,401895,CDM,637,RC,,,outpatient,,,19.74,12.83,,13.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.79,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.28,18.75,
NF-TRI-SPRINTEC 28 ORAL TABLET,401896,CDM,637,RC,,,outpatient,,,4.21,2.74,,2.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.79,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.13,4,
NF-SILDENAFIL CITRATE TAB 20MG,401897,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-ABILIFY 20MG ORAL TABLET,401898,CDM,637,RC,,,outpatient,,,113.56,73.81,,76.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,102.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,90.85,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,85.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,96.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,68.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.4,107.88,
NF-PREMARIN ORAL TABLET 0.3MG,401899,CDM,637,RC,,,outpatient,,,8.25,5.36,,5.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.43,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.21,7.84,
NF-XIFAXAN ORAL TABLET 550MG,401900,CDM,637,RC,,,outpatient,,,79.29,51.54,,53.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,71.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,63.43,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,59.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,47.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.23,75.33,
NF-ABILIFY ORAL TABLET 5MG,401901,CDM,637,RC,,,outpatient,,,69,44.85,,46.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,62.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,55.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.47,65.55,
NF-ABILIFY ORAL TABLET 5MG,401902,CDM,637,RC,,,outpatient,,,55.4,36.01,,37.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.83,52.63,
NF-RIFAXIMIN TAB 550MG,401904,CDM,637,RC,,,outpatient,,,99.11,64.42,,66.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.29,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.53,94.15,
NF-MIDODRINE HCL TAB 5MG,401905,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-SIMBRINZA 0.2%-1% OPHTHALMIC SUSPENSI,401906,CDM,637,RC,,,outpatient,,,39.44,25.64,,26.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.55,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.47,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.56,37.47,
NF-LINZESS CAP 290MCG,401907,CDM,637,RC,,,outpatient,,,27.73,18.02,,18.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.57,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.42,26.34,
NF-MIDODRINE HCL ORAL TABLET 5MG,401908,CDM,637,RC,,,outpatient,,,12.47,8.11,,8.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.34,11.85,
NF-ZIAC TAB 10MG-6.25MG,401909,CDM,637,RC,,,outpatient,,,2.46,1.6,,1.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.66,2.34,
NF-OCELLA TAB 3MG-0.03MG-NO STRENGTH,401910,CDM,637,RC,,,outpatient,,,9.5,6.18,,6.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.54,9.03,
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,401911,CDM,637,RC,,,outpatient,,,426,276.9,,285.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,310.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,383.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,118.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,340.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,319.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,120.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,114.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,404.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,362.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,255.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.04,404.7,
NF-BC ORAL POWDER 845MG-65MG/1 PACKET,401912,CDM,637,RC,,,outpatient,,,0.42,0.27,,0.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.11,0.4,
NF-MINOCIN CAP 100MG,401914,CDM,637,RC,,,outpatient,,,44.32,28.81,,29.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33.24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.86,42.1,
NF-TARCEVA ORAL TABLET 150MG,401915,CDM,637,RC,,,outpatient,,,390.67,253.94,,261.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,285.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,351.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,108.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,312.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,293,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,110.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,104.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,371.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,106.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,332.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,234.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.58,371.14,
NF-TARCEVA TAB 150MG,401916,CDM,637,RC,,,outpatient,,,551.09,358.21,,369.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,154.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,154.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,402.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,495.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,153.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,440.87,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,413.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,155.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,147.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,154.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,523.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,150.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,468.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,330.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,154.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,330.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,147.53,523.54,
NF-RIFAXIMIN TAB 550MG,401918,CDM,637,RC,,,outpatient,,,99.11,64.42,,66.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.29,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.53,94.15,
NF-SYNTHROID ORAL TABLET 0.137MG,401919,CDM,637,RC,,,outpatient,,,3.24,2.11,,2.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.59,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.87,3.08,
NF-CLOZAPINE ORAL TABLET 25MG,401920,CDM,637,RC,,,outpatient,,,3.85,2.5,,2.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.89,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.03,3.66,
NF-CLOZAPINE TAB 100MG,401921,CDM,637,RC,,,outpatient,,,37.33,24.26,,25.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.99,35.46,
NF-PROCARDIA XL TABLET 30MG,401922,CDM,637,RC,,,outpatient,,,12.11,7.87,,8.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.69,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.24,11.5,
LABETALOL (TRANDATE) INJ: 20MG/4ML,401924,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-SYSTANE BALANCE OPHTH SOLN 0.6%,401925,CDM,637,RC,,,outpatient,,,3.13,2.03,,2.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.84,2.97,
NF-REFRESH OPTIVE SENSITIVE OPHTH SOLN,401926,CDM,637,RC,,,outpatient,,,0.93,0.6,,0.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.25,0.88,
NF-BUSPIRONE HCL TAB 15MG,401927,CDM,637,RC,,,outpatient,,,6.06,3.94,,4.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.85,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.62,5.76,
NF-POLYMYXIN B-TRIMETHOPRIM SULFATE OPHT,401928,CDM,637,RC,,,outpatient,,,4.57,2.97,,3.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.22,4.34,
NF-VALSARTAN AND HYDROCHLOROTHIAZIDE TAB,401929,CDM,637,RC,,,outpatient,,,18.43,11.98,,12.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.82,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.93,17.51,
NF-REFRESH PM OPHTH OINTMENT,401930,CDM,637,RC,,,outpatient,,,5.11,3.32,,3.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.37,4.85,
NF-REFRESH LIQUIGEL OPHTH GEL 1%,401931,CDM,637,RC,,,outpatient,,,1.76,1.14,,1.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.47,1.67,
NF-GAS-X ES ORAL LIQUIDFILLED CAPSULE 12,401932,CDM,637,RC,,,outpatient,,,0.63,0.41,,0.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.57,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.17,0.6,
NF-REFRESH PM OPHTH OINTMENT 42.5%-57.3%,401933,CDM,637,RC,,,outpatient,,,5.11,3.32,,3.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.37,4.85,
NF-REFRESH TEARS OPHTH SOLUTION 0.5%,401934,CDM,637,RC,,,outpatient,,,1.76,1.14,,1.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.47,1.67,
NF-QVAR INH/NEB AER LIQ 0.08MG/1 ACTUATI,401935,CDM,637,RC,,,outpatient,,,72.23,46.95,,48.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,65.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.34,68.62,
NF-QVAR INH/NEB AER LIQ 0.08MG/1 ACTUATI,401936,CDM,637,RC,,,outpatient,,,64.57,41.97,,43.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.29,61.34,
NF-QVAR INH/NEB AER LIQ 0.08MG/1 ACTUATI,401937,CDM,637,RC,,,outpatient,,,57.81,37.58,,38.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.03,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.25,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.92,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.48,54.92,
NF-DANTROLENE SODIUM 100MG ORAL CAPSULE,401938,CDM,637,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
NF-SAPHRIS SL TAB 5MG,401939,CDM,637,RC,,,outpatient,,,41.38,26.9,,27.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.24,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.08,39.31,
NF-IPRATROPIUM BROMIDE 0.03% NASAL SPRAY,401940,CDM,637,RC,,,outpatient,,,6.15,4,,4.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.65,5.84,
NF-BUSPAR 5MG ORAL TABLET,401941,CDM,637,RC,,,outpatient,,,4.88,3.17,,3.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.9,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.31,4.64,
NF-BUSPIRONE HCL TAB 15MG,401943,CDM,637,RC,,,outpatient,,,6.06,3.94,,4.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.85,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.62,5.76,
NF-METHADONE HCL TABLET 10MG,401946,CDM,637,RC,,,outpatient,,,1.31,0.85,,0.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.05,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.98,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.35,1.24,
NF-INSPRA TAB 25MG,401947,CDM,637,RC,,,outpatient,,,22.41,14.57,,15.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.93,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6,21.29,
NF-ALTACE CAP 5MG,401948,CDM,637,RC,,,outpatient,,,7.07,4.6,,4.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.89,6.72,
NF-AZATHIOPRINE ORAL TABLET 50MG,401949,CDM,637,RC,,,outpatient,,,2.49,1.62,,1.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.24,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.37,
NF-MILK OF MAGNESIA SUSP 400MG/5ML,401950,CDM,637,RC,,,outpatient,,,0.02,0.01,,0.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.02,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.02,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.01,0.02,
FLUARIX QIV 0.5ML INJ (2020-21),401951,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-DORZOLAMIDE HYDROCHLORIDE 2% OPHTHALM,401952,CDM,637,RC,,,outpatient,,,20.04,13.03,,13.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.36,19.04,
NF-MIDODRINE HCL 5MG ORAL TABLET,401953,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
NF-ANASTROZOLE,401954,CDM,637,RC,,,outpatient,,,44.64,29.02,,29.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,40.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.71,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.94,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.95,42.41,
NF-LISINOPRIL AND HYDROCHLOROTHIAZIDE 12,401955,CDM,637,RC,,,outpatient,,,4.6,2.99,,3.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.91,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.23,4.37,
NF-BUPROPION HCL 24 HR TAB ER 300MG,401956,CDM,637,RC,,,outpatient,,,21.51,13.98,,14.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.21,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.76,20.43,
NF-METOPROLOL SUCCINATE ORAL TAB ER 100M,401957,CDM,637,RC,,,outpatient,,,5.42,3.52,,3.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.45,5.15,
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,401958,CDM,637,RC,,,outpatient,,,9.89,6.43,,6.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.41,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.65,9.4,
NF-LEVEMIR  SUBQ SOLN 100U/1ML,401959,CDM,637,RC,,,outpatient,,,79.95,51.97,,53.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,71.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,63.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,59.96,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.96,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,47.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.4,75.95,
NF-HUMALOG INJECTION 100U/ML,401960,CDM,637,RC,,,outpatient,,,66.35,43.13,,44.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.76,63.03,
NF-TRAVOPROST OPHTH SOLN 0.004%,401961,CDM,637,RC,,,outpatient,,,153,99.45,,102.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,137.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,122.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,114.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,130.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.96,145.35,
NF-METHOTREXATE SODIUM 25MG/ML INJECTION,401962,CDM,637,RC,,,outpatient,,,8.4,5.46,,5.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.25,7.98,
NF-LISINOPRIL AND HYDROCHLOROTHIAZIDE 12,401963,CDM,637,RC,,,outpatient,,,4.32,2.81,,2.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.16,4.1,
NF-TARCEVA 150MG ORAL TABLET,401965,CDM,637,RC,,,outpatient,,,745.44,484.54,,499.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,208.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,544.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,670.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,207.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,596.35,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,559.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,210.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,199.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,708.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,203.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,633.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,447.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,447.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,203.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,199.55,708.17,
NF-ATRIPLA ORAL TABLET 600MG-200MG-300MG,401966,CDM,637,RC,,,outpatient,,,246.24,160.06,,164.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,179.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,221.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,68.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,196.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,184.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,233.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,209.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,147.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.92,233.93,
"NF-NIFEDIPINE 30MG ORAL TABLET, EXTENDED",401967,CDM,637,RC,,,outpatient,,,5.01,3.26,,3.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.51,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.01,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,4.76,
NF-SYSTANE OPHTHALMIC OINTMENT 3%-94%,401968,CDM,637,RC,,,outpatient,,,7.51,4.88,,5.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.01,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.01,7.13,
NF-RAPAFLO 8MG ORAL CAPSULE,401969,CDM,637,RC,,,outpatient,,,15.05,9.78,,10.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.03,14.3,
NF-,401970,CDM,637,RC,,,outpatient,,,95.85,62.3,,64.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,86.27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,71.89,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.66,91.06,
NF-RAPAFLO CAP 8MG,401971,CDM,637,RC,,,outpatient,,,18.11,11.77,,12.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.39,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.85,17.2,
NF-LOTENSIN HCT 20MG-12.5MG ORAL TABLET,401972,CDM,637,RC,,,outpatient,,,6.9,4.49,,4.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.85,6.56,
NF-LOTREL 10MG-40MG ORAL CAPSULE,401974,CDM,637,RC,,,outpatient,,,21.24,13.81,,14.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.69,20.18,
NF-NORTRIPTYLINE HCL CAP 25MG,401975,CDM,637,RC,,,outpatient,,,2.65,1.72,,1.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.71,2.52,
NF-BUSPIRONE 5MG ORAL TABLET,401976,CDM,637,RC,,,outpatient,,,2.41,1.57,,1.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.93,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.65,2.29,
NF-MILK OF MAGNESIA SUSP 1200MG/5ML,401977,CDM,637,RC,,,outpatient,,,0.07,0.05,,0.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.07,
NF-CIPRO TAB 250MG,401978,CDM,637,RC,,,outpatient,,,15.29,9.94,,10.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.09,14.53,
NF-BRIMONIDINE TARTRATE 0.15% OPHTHALMIC,401979,CDM,637,RC,,,outpatient,,,63.55,41.31,,42.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.01,60.37,
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,401980,CDM,637,RC,,,outpatient,,,63.55,41.31,,42.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.01,60.37,
NF-FOSAMAX 70MG ORAL TABLET,401981,CDM,637,RC,,,outpatient,,,83.63,54.36,,56.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.9,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.39,79.45,
NF-PREMARIN 0.9MG ORAL TABLET,401982,CDM,637,RC,,,outpatient,,,4.36,2.83,,2.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.17,4.14,
NF-ARICEPT 10MG ORAL TABLET,401984,CDM,637,RC,,,outpatient,,,41.54,27,,27.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.12,39.46,
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,401985,CDM,637,RC,,,outpatient,,,64.08,41.65,,42.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.67,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.15,60.88,
NF-XOPENEX INH/NEB SOLN 1.25MG/3ML,401986,CDM,637,RC,,,outpatient,,,7.45,4.84,,4.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.99,7.08,
NF-IPRATROPIUM BROMIDE INH SOLN 0.02%,401987,CDM,637,RC,,,outpatient,,,0.22,0.14,,0.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,0.21,
NF-ZESTRIL 10MG ORAL TABLET,401988,CDM,637,RC,,,outpatient,,,4.21,2.74,,2.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.79,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.13,4,
NF-NEVANAC OPHTH SUSP 0.1%,401989,CDM,637,RC,,,outpatient,,,218.28,141.88,,146.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,61.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,159.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,196.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,60.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,174.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,163.71,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,61.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,58.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,207.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,59.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,185.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,130.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,130.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.43,207.37,
NF-STIVARGA TAB 40MG,401990,CDM,637,RC,,,outpatient,,,468.29,304.39,,313.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,131.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,131.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,341.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,421.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,130.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,374.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,351.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,132.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,125.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,131.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,444.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,127.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,398.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,280.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,280.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,125.36,444.88,
NF-XENADERM OINT 788MG-87MG-90U/1GM,401991,CDM,637,RC,,,outpatient,,,3.47,2.26,,2.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.93,3.3,
NF-SYSTANE 0.4%-0.3% OPHTHALMIC SOLUTION,401993,CDM,637,RC,,,outpatient,,,1.53,0.99,,1.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.41,1.45,
"NF-DILTIAZEM CD 240MG ORAL CAPSULE, EXTE",401994,CDM,637,RC,,,outpatient,,,55.89,36.33,,37.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.71,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.92,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.96,53.1,
NF-LETAIRIS TAB 5MG,401995,CDM,637,RC,,,outpatient,,,827.2,537.68,,554.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,231.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,221.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,231.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,603.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,744.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,230.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,661.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,620.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,233.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,221.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,231.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,785.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,225.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,703.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,496.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,496.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,221.44,785.84,
NF-PREMARIN ORAL TABLET 0.9MG,401996,CDM,637,RC,,,outpatient,,,9.8,6.37,,6.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.62,9.31,
NF-PREMARIN ORAL TABLET 0.9MG,401997,CDM,637,RC,,,outpatient,,,11.92,7.75,,7.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.73,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.19,11.32,
NF-DOXEPIN HCL CAP 50MG,401998,CDM,637,RC,,,outpatient,,,2.67,1.74,,1.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.71,2.54,
NF-AFRIN NASAL SPRAY 0.05%,401999,CDM,637,RC,,,outpatient,,,0.79,0.51,,0.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.21,0.75,
NF-PREVACID CAP DR 15MG,402000,CDM,637,RC,,,outpatient,,,2.58,1.68,,1.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.69,2.45,
NF-METHOTREXATE SODIUM 2.5MG ORAL TABLET,402001,CDM,637,RC,,,outpatient,,,21.3,13.85,,14.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.98,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.7,20.24,
NF-FISH OIL REGULAR WITH NATURAL OMEGA-3,402002,CDM,637,RC,,,outpatient,,,0.21,0.14,,0.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.19,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,0.2,
NF-CRANBERRY CAPSULE 400MG,402003,CDM,637,RC,,,outpatient,,,0.42,0.27,,0.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.11,0.4,
NF-HYDROXYZINE HCL ORAL TAB 10MG,402004,CDM,637,RC,,,outpatient,,,1.46,0.95,,0.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.31,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.39,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.39,1.39,
NF-VESICARE ORAL TABLET 10MG,402005,CDM,637,RC,,,outpatient,,,26.54,17.25,,17.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.91,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.1,25.21,
NF-FENOFIBRATE CAP 134MG,402006,CDM,637,RC,,,outpatient,,,5.88,3.82,,3.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.29,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.57,5.59,
RX LIDOCAINE/D5W PREMX: 2GM/500ML,402007,CDM,636,RC,,,both,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
MAGNESIUM SULF PREMIX: 4 GM/50 ML,402008,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
LEVOFLOXACIN (LEVAQUIN) TABLET: 250 MG,402009,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-ORTHO TRI-CYCLEN 35MCG-0.18MG\;35MCG-,402010,CDM,637,RC,,,outpatient,,,3.38,2.2,,2.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.9,3.21,
NF-TOBRADEX OPHTH OINT 0.3?.1?,402011,CDM,637,RC,,,outpatient,,,177.33,115.26,,118.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,49.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,159.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,49.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,141.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,133,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,50.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,47.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,168.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,48.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,150.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,106.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.47,168.46,
NF-TAMBOCOR 100MG ORAL TABLET,402019,CDM,637,RC,,,outpatient,,,9.29,6.04,,6.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.43,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.97,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.49,8.83,
NF-SARNA 0.5%-0.5% TOPICAL APPLICATION L,402021,CDM,637,RC,,,outpatient,,,0.11,0.07,,0.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.03,0.1,
NF-GENTEAL OPHTHALMIC GEL 0.25%-0.3%,402025,CDM,637,RC,,,outpatient,,,1.62,1.05,,1.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,1.54,
NF-REFRESH PLUS OPHTH SOLUTION,402026,CDM,637,RC,,,outpatient,,,0.62,0.4,,0.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.17,0.59,
NF-REFRESH PLUS OPHTH SOLUTION,402027,CDM,637,RC,,,outpatient,,,0.91,0.59,,0.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.73,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
NF-GENTEAL PM OINTMENT,402028,CDM,637,RC,,,outpatient,,,6.93,4.5,,4.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.24,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.86,6.58,
NF-MIRAPEX ORAL TABLET 1MG,402029,CDM,637,RC,,,outpatient,,,6.68,4.34,,4.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.79,6.35,
NF-SILDENAFIL 20MG ORAL TABLET,402030,CDM,637,RC,,,outpatient,,,63.21,41.09,,42.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,56.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.57,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.92,60.05,
NF-MEDIHONEY TOPICAL GEL 80%,402031,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-ABILIFY ORAL TABLET 2MG,402032,CDM,637,RC,,,outpatient,,,103.79,67.46,,69.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,93.41,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,83.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,77.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,88.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,62.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.78,98.6,
NF-PULMICORT RESPULES INH SUSP 0.5MG/2ML,402033,CDM,637,RC,,,outpatient,,,14.45,9.39,,9.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.87,13.73,
NF-INDAPAMIDE 1.25MG ORAL TABLET,402034,CDM,637,RC,,,outpatient,,,0.43,0.28,,0.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.12,0.41,
PHENAZOPYRIDINE (PYRIDIUM) TAB: 95 MG,402036,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CETIRIZINE/PSEUD (ZYRTEC D) TAB: 5/120MG,402037,CDM,250,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-LAMICTAL 100MG ORAL TABLET,402038,CDM,637,RC,,,outpatient,,,29.99,19.49,,20.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.99,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.49,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.49,
NF-SULFADIAZINE 500MG ORAL TABLET,402039,CDM,637,RC,,,outpatient,,,12.35,8.03,,8.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.26,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.31,11.73,
NF-LAMICTAL 25MG-100MG ORAL TABLET,402040,CDM,637,RC,,,outpatient,,,16.39,10.65,,10.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.11,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.39,15.57,
NF-DEPAKOTE SPRINKLES CAP DR 125MG,402041,CDM,637,RC,,,outpatient,,,5.41,3.52,,3.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.87,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.33,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.45,5.14,
NF-DEPAKOTE SPRINKLES CAP DR 125MG,402042,CDM,637,RC,,,outpatient,,,5.41,3.52,,3.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.87,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.33,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.45,5.14,
NF-LAMICTAL ORAL TABLET 100MG,402043,CDM,637,RC,,,outpatient,,,21.25,13.81,,14.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.69,20.19,
NF-LAMICTAL TAB 25MG,402044,CDM,637,RC,,,outpatient,,,30.69,19.95,,20.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.55,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.02,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.22,29.16,
NF-SULFADIAZINE TABLET 500MG,402045,CDM,637,RC,,,outpatient,,,13.78,8.96,,9.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.69,13.09,
NF-ACEBUTOLOL HYDROCHLORIDE 200MG ORAL C,402046,CDM,637,RC,,,outpatient,,,3.25,2.11,,2.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.93,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.76,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.87,3.09,
AMOXICILLIN (AMOXIL) ORAL SUSP:400MG/5ML,402047,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-NEXPLANON 68MG INTRADERMAL IMPLANT,402048,CDM,637,RC,,,outpatient,,,2777.46,1805.35,,1860.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,777.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,743.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,777.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2027.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2499.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,773.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2221.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2083.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,785.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,743.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,777.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2638.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,758.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2360.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1666.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,777.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1666.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,758.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,743.53,2638.59,
NF-SYSTANE OPHTHALMIC GEL/JELLY 0.3%,402049,CDM,637,RC,,,outpatient,,,3.06,1.99,,2.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.45,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.91,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.82,2.91,
NF-CLINDAMYCIN HCL CAP 300MG,402050,CDM,637,RC,,,outpatient,,,12.22,7.94,,8.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.39,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.27,11.61,
NF-PREMARIN ORAL TABLET 0.45MG,402051,CDM,637,RC,,,outpatient,,,13.05,8.48,,8.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.79,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.49,12.4,
NF-FOSAMAX TAB 70MG,402052,CDM,637,RC,,,outpatient,,,100.85,65.55,,67.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75.64,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.81,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.72,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27,95.81,
NF-WELLBUTRIN 75MG ORAL TABLET,402053,CDM,637,RC,,,outpatient,,,3.99,2.59,,2.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.19,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.79,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.39,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.79,
NF-KETOTIFEN FUMARATE OPHTH SOLN 0.025%,402054,CDM,637,RC,,,outpatient,,,28.71,18.66,,19.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.69,27.27,
NF-WELCHOL 3.75GM/1 PACKET ORAL POWDER F,402055,CDM,637,RC,,,outpatient,,,29.34,19.07,,19.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.41,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.47,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.87,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.94,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.85,27.87,
NF-COMBIVENT RESPIMAT INH 100MCG-20MCG/A,402056,CDM,637,RC,,,outpatient,,,251.07,163.2,,168.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,70.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,70.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,183.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,225.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,69.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,200.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,188.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,67.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,70.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,238.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,68.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,213.41,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,150.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.21,238.52,
"NF-NIFEDIPINE ER 30MG ORAL TABLET, EXTEN",402057,CDM,637,RC,,,outpatient,,,4.58,2.98,,3.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.23,4.35,
NF-ELIQUIS ORAL TABLET 2.5MG,402058,CDM,637,RC,,,outpatient,,,18.9,12.29,,12.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.06,17.96,
NF-SIMVASTATIN ORAL TABLET  20MG,402059,CDM,637,RC,,,outpatient,,,14.76,9.59,,9.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.81,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.95,14.02,
NF-NAMENDA XR CAP ER 7MG,402060,CDM,637,RC,,,outpatient,,,35.63,23.16,,23.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.54,33.85,
NF-NAMENDA XR CAP ER 14MG,402061,CDM,637,RC,,,outpatient,,,35.63,23.16,,23.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.54,33.85,
NF-NAMENDA XR CAP ER 21MG,402062,CDM,637,RC,,,outpatient,,,35.63,23.16,,23.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.54,33.85,
NF-NAMENDA XR CAP ER 28MG,402063,CDM,637,RC,,,outpatient,,,35.62,23.15,,23.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.54,33.84,
NF-MIDODRINE HCL ORAL TABLET 5MG,402064,CDM,637,RC,,,outpatient,,,12.47,8.11,,8.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.34,11.85,
NF-MIDODRINE HCL ORAL TABLET 5MG,402065,CDM,637,RC,,,outpatient,,,12.47,8.11,,8.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.34,11.85,
NF-LUBIPROSTONE LIQ CAP 24MCG,402067,CDM,637,RC,,,outpatient,,,23.48,15.26,,15.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.96,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.29,22.31,
NF-MELATONIN ORAL TABLET 5MG,402068,CDM,637,RC,,,outpatient,,,0.26,0.17,,0.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.21,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.07,0.25,
NF-BUSPIRONE HCL ORAL TABLET 15MG,402069,CDM,637,RC,,,outpatient,,,5.97,3.88,,4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.6,5.67,
NF-LAMISIL TAB 250MG,402070,CDM,637,RC,,,outpatient,,,81.02,52.66,,54.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64.82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.77,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.69,76.97,
NF-BETAMETHASONE DIPROPIONATE AUGMENTED,402071,CDM,637,RC,,,outpatient,,,8.2,5.33,,5.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.79,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.2,7.79,
NF-GAVISCON EXTRA STRENGTH ORAL CHEW TAB,402072,CDM,637,RC,,,outpatient,,,0.25,0.16,,0.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.07,0.24,
NF-CALCIUM CITRATE + D TABLET,402073,CDM,637,RC,,,outpatient,,,0.24,0.16,,0.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.19,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,0.23,
NF-AMITIZA LIQ CAP 8MCG,402074,CDM,637,RC,,,outpatient,,,17.97,11.68,,12.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.81,17.07,
NF-VALSARTAN AND HCTZ TABLET 80MG/12.5MG,402075,CDM,637,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
NF-MIDODRINE HCL TABLET 5MG,402076,CDM,637,RC,,,outpatient,,,7.25,4.71,,4.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.53,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.89,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.94,6.89,
HYDRALAZINE INJECTION: 20 MG/ML,402077,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-AZOPT 1% OPHTHALMIC SUSPENSION,402079,CDM,637,RC,,,outpatient,,,71.99,46.79,,48.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.79,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.59,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,53.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.39,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.39,
NF-PILOCARPINE HCL 4% OPHTHALMIC SOLUTIO,402080,CDM,637,RC,,,outpatient,,,2.11,1.37,,1.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.69,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.56,2,
NF-RESTASIS 0.05% OPHTHALMIC EMULSION,402081,CDM,637,RC,,,outpatient,,,21.28,13.83,,14.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.96,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.22,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.7,20.22,
3% SODIUM CHLORIDE INJ: 500 ML,402082,CDM,258,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
NF-LEVOFLOXACIN ORAL TABLET 500MG,402084,CDM,637,RC,,,outpatient,,,57.87,37.62,,38.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.49,54.98,
NF-PULMICORT INH/NEB SUSP 0.25MG/2ML,402085,CDM,637,RC,,,outpatient,,,11.71,7.61,,7.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.13,11.12,
NF-LOPERAMIDE HCL ORAL SOLN 1MG/7.5ML,402086,CDM,637,RC,,,outpatient,,,0.14,0.09,,0.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.11,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.11,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.04,0.13,
NF-LAMOTRIGINE ORAL TABLET 150MG,402087,CDM,637,RC,,,outpatient,,,15.62,10.15,,10.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.18,14.84,
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,402088,CDM,637,RC,,,outpatient,,,13.92,9.05,,9.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.53,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.22,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.73,13.22,
NF-LAMOTRIGINE CHEW TAB 25MG,402089,CDM,637,RC,,,outpatient,,,31.88,20.72,,21.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.91,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.53,30.29,
KETAMINE INJECTION: 50 MG/1 ML SYR,402090,CDM,250,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NF-LETAIRIS ORAL TABLET 5MG,402091,CDM,637,RC,,,outpatient,,,884.27,574.78,,592.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,247.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,236.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,247.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,645.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,795.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,246.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,707.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,663.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,250.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,236.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,247.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,840.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,241.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,751.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,530.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,530.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,236.72,840.06,
NF-DOXEPIN HCL CAP 100MG,402092,CDM,637,RC,,,outpatient,,,5.38,3.5,,3.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.57,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.44,5.11,
NF-PREMARIN ORAL TABLET 0.9MG,402094,CDM,637,RC,,,outpatient,,,6.32,4.11,,4.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.74,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.69,6,
NF-DOXEPIN HCL CAP 50MG,402095,CDM,637,RC,,,outpatient,,,1.04,0.68,,0.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.28,0.99,
ISOFLORANE (TERRELL) LIQUID 100 ML BOTTL,402096,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-SOTALOL HCL AF TABLET 120MG,402098,CDM,637,RC,,,outpatient,,,12.91,8.39,,8.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.33,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.46,12.26,
NF-ANORO ELLIPTA INH PWD 62.5MCG-25MCG/1,402099,CDM,637,RC,,,outpatient,,,17.87,11.62,,11.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.78,16.98,
NF-EPLERENONE ORAL TABLET 25MG,402100,CDM,637,RC,,,outpatient,,,19.73,12.82,,13.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.74,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.28,18.74,
NF-TIMOLOL MALEATE 0.25% OPHTHALMIC SOLU,402101,CDM,637,RC,,,outpatient,,,6.95,4.52,,4.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.91,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.86,6.6,
NF-MIDODRINE HCL 5MG ORAL TABLET,402102,CDM,637,RC,,,outpatient,,,7.26,4.72,,4.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.53,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.81,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.94,6.9,
NF-PILOCARPINE HCL OPHTH SOLN 1%,402103,CDM,637,RC,,,outpatient,,,19.71,12.81,,13.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.77,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.28,18.72,
NF-MIDODRINE HCL 10MG ORAL TABLET,402105,CDM,637,RC,,,outpatient,,,14.51,9.43,,9.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.61,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.88,13.78,
NF-TIMOLOL MALEATE OPHTH GEL DROP 0.25%,402106,CDM,637,RC,,,outpatient,,,82.74,53.78,,55.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,74.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.19,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.15,78.6,
NF-BYSTOLIC 5MG ORAL TABLET,402107,CDM,637,RC,,,outpatient,,,11.12,7.23,,7.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.9,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.98,10.56,
NF-LAMICTAL TAB 150MG,402108,CDM,637,RC,,,outpatient,,,5.53,3.59,,3.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.48,5.25,
NF-DEPAKOTE ER EXTENDED-RELEASE TAB 250M,402109,CDM,637,RC,,,outpatient,,,9.53,6.19,,6.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,9.05,
NF-DEPAKOTE ER TABLET 500MG,402110,CDM,637,RC,,,outpatient,,,16.76,10.89,,11.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.92,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.49,15.92,
NF-GEMFIBROZIL TAB 600MG,402111,CDM,637,RC,,,outpatient,,,6.57,4.27,,4.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.91,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.76,6.24,
NF-DOXEPIN HCL CAP 50MG,402113,CDM,637,RC,,,outpatient,,,1.35,0.88,,0.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.36,1.28,
NF-CLOBETASOL PROPIONATE 0.05% TOPICAL A,402114,CDM,637,RC,,,outpatient,,,3.39,2.2,,2.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.71,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.22,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.91,3.22,
NF-MIRALAX ORAL PWD FOR SOLN 17GM/1DOSE,402116,CDM,637,RC,,,outpatient,,,0.12,0.08,,0.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.09,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.03,0.11,
NF-ACETAMINOPHEN EXTRA STRENGT TABLET 50,402117,CDM,637,RC,,,outpatient,,,0.05,0.03,,0.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.04,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.01,0.05,
NF-TRADJENTA 5MG ORAL TABLET,402118,CDM,637,RC,,,outpatient,,,39.68,25.79,,26.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.62,37.7,
NF-WELLBUTRIN XL 24 HR TAB ER 300MG,402121,CDM,637,RC,,,outpatient,,,26.26,17.07,,17.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.01,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.03,24.95,
NF-LYRICA CAP 225MG,402122,CDM,637,RC,,,outpatient,,,18.92,12.3,,12.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.03,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.06,17.97,
NF-TEGASORB HYDROCOLLOID,402123,CDM,637,RC,,,outpatient,,,12.3,8,,8.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.29,11.69,
NF-PRADAXA 150MG ORAL CAPSULE,402124,CDM,637,RC,,,outpatient,,,18.08,11.75,,12.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.56,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.84,17.18,
NF-BENICAR ORAL TABLET 40MG,402125,CDM,637,RC,,,outpatient,,,24.3,15.8,,16.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.87,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.51,23.09,
NF-SCOPOLAMINE TD PATCH ER 1.5MG,402126,CDM,637,RC,,,outpatient,,,14.79,9.61,,9.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.31,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.09,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.57,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.96,14.05,
NF-LEVOTHYROXINE ORAL TABLET 112MCG,402127,CDM,637,RC,,,outpatient,,,1.75,1.14,,1.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.31,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.49,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.47,1.66,
NF-CALCIUM 600/VITAMIN D CAPSULE,402128,CDM,637,RC,,,outpatient,,,0.17,0.11,,0.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.05,0.16,
NF-LUBIPROSTONE LIQ CAP 24MCG,402131,CDM,637,RC,,,outpatient,,,15.62,10.15,,10.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.18,14.84,
NF-SYNTHROID ORAL TABLET 112MCG,402133,CDM,637,RC,,,outpatient,,,1.26,0.82,,0.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.01,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.34,1.2,
NF-OCUVITE TABLET,402134,CDM,637,RC,,,outpatient,,,0.29,0.19,,0.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.08,0.28,
NF-CELEBREX CAP 200MG,402135,CDM,637,RC,,,outpatient,,,22.38,14.55,,14.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.9,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.79,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.99,21.26,
NF-BUTRANS TD PATCH ER 10MCG/1HR,402137,CDM,637,RC,,,outpatient,,,252.08,163.85,,168.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,70.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,70.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,184.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,226.87,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,70.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,201.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,189.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,71.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,67.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,70.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,239.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,68.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,214.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,151.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,151.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.48,239.48,
"NF-NIFEDIPINE 30MG ORAL TABLET, EXTENDED",402138,CDM,637,RC,,,outpatient,,,3.89,2.53,,2.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.11,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.92,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.04,3.7,
NF-CRESTOR TAB 5MG,402139,CDM,637,RC,,,outpatient,,,25.93,16.85,,17.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.04,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.94,24.63,
NF-TRUVADA ORAL TABLET 200MG-300MG,402140,CDM,637,RC,,,outpatient,,,231.2,150.28,,154.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,64.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,64.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,168.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,208.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,64.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,184.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,173.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,65.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,61.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,64.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,219.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,63.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,196.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,138.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.89,219.64,
NF-LITHIUM CARBONATE ORAL TABLET 300MG,402141,CDM,637,RC,,,outpatient,,,0.62,0.4,,0.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.17,0.59,
NF-MEPILEX FOAM DRESSING,402142,CDM,637,RC,,,outpatient,,,27.18,17.67,,18.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.28,25.82,
NF-OCUVITE ADULT 50+ LIQUID-FILLED CAPSU,402144,CDM,637,RC,,,outpatient,,,0.79,0.51,,0.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.21,0.75,
NF-CALCIUM CARBONATE/VITAMIN D 400IU-600,402146,CDM,637,RC,,,outpatient,,,0.12,0.08,,0.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.09,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.03,0.11,
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,402147,CDM,637,RC,,,outpatient,,,31.93,20.75,,21.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.55,30.33,
NF-ATROVENT HFA SOLN INH ORAL NEB 0.017M,402149,CDM,637,RC,,,outpatient,,,72.53,47.14,,48.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,65.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,58.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.42,68.9,
NF-DAPSONE 100MG ORAL TABLET,402150,CDM,637,RC,,,outpatient,,,3.9,2.54,,2.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.51,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.04,3.71,
NF-CLOZAPINE ORAL TABLET 25MG,402152,CDM,637,RC,,,outpatient,,,3.75,2.44,,2.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1,3.56,
NF-CLOZAPINE ORAL TABLET 100MG,402153,CDM,637,RC,,,outpatient,,,9.98,6.49,,6.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.67,9.48,
NF-CLOZARIL TABLET 25MG,402154,CDM,637,RC,,,outpatient,,,17.38,11.3,,11.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.9,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.65,16.51,
NF-SODIUM CHLORIDE TABLET 1GM,402155,CDM,637,RC,,,outpatient,,,0.17,0.11,,0.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.05,0.16,
NF-TACROLIMUS 1MG ORAL CAPSULE,402156,CDM,637,RC,,,outpatient,,,13.38,8.7,,8.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.58,12.71,
NF-TACROLIMUS 1MG ORAL CAPSULE,402157,CDM,637,RC,,,outpatient,,,13.38,8.7,,8.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.58,12.71,
NF-MYCOPHENOLATE MOFETIL 500MG ORAL TABL,402158,CDM,637,RC,,,outpatient,,,4.69,3.05,,3.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.75,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.52,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.26,4.46,
NF-MYCOPHENOLATE MOFETIL TAB 500MG,402159,CDM,637,RC,,,outpatient,,,51.43,33.43,,34.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.29,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.72,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.77,48.86,
LAMIVUDINE-ZIDOVUDINE TAB: 150MG-300MG,402160,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
LOPINAVIR/RITONAVIR TAB: 100MG-25MG,402161,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-TIVICAY 50MG ORAL TABLET,402162,CDM,637,RC,,,outpatient,,,158.17,102.81,,105.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,44.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,142.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,44.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,126.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,118.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,44.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,42.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,43.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,94.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.34,150.26,
NF-MEPRON 750MG/5ML ORAL SUSPENSION,402164,CDM,637,RC,,,outpatient,,,7.48,4.86,,5.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.73,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2,7.11,
NF-DIFLUPREDNATE OPHTH EMUL 0.05%,402165,CDM,637,RC,,,outpatient,,,77.18,50.17,,51.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,69.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,61.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,57.89,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,46.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.66,73.32,
NF-NEPAFENAC OPHTH SUSP 0.3%,402166,CDM,637,RC,,,outpatient,,,476.47,309.71,,319.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,133.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,347.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,428.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,132.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,381.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,357.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,134.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,127.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,452.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,130.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,405,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,285.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,285.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,127.55,452.65,
NF-MEPRON SUSP 750MG/5ML,402167,CDM,637,RC,,,outpatient,,,11.68,7.59,,7.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.51,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.13,11.1,
NF-LITHIUM CARBONATE TAB 300MG,402168,CDM,637,RC,,,outpatient,,,0.65,0.42,,0.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.17,0.62,
NF-NEPAFENAC OPHTH SUSP 0.3%,402169,CDM,637,RC,,,outpatient,,,385.2,250.38,,258.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,107.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,107.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,346.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,107.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,308.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,288.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,108.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,103.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,107.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,365.94,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,105.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,327.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,231.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,231.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,103.12,365.94,
NF-BETAXOLOL HCL OPHTH SUSP 0.25%,402170,CDM,637,RC,,,outpatient,,,98.15,63.8,,65.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.27,93.24,
NF-MURO-128 OPHTH SOLUTION 5%,402171,CDM,637,RC,,,outpatient,,,20.4,13.26,,13.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.46,19.38,
NF-BIMATOPROST OPHTH SOLN 0.03%,402172,CDM,637,RC,,,outpatient,,,140.4,91.26,,94.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.59,133.38,
NF-B-COMPLEX TABLET,402173,CDM,637,RC,,,outpatient,,,0.16,0.1,,0.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.13,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.04,0.15,
NF-LISINOPRIL ORAL TABLET 5MG,402174,CDM,637,RC,,,outpatient,,,2.92,1.9,,1.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.78,2.77,
NF-VITAMIN D3 ORAL TABLET 1000IU,402175,CDM,637,RC,,,outpatient,,,0.09,0.06,,0.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.09,
NF-IBUPROFEN ORAL TABLET 200MG,402176,CDM,637,RC,,,outpatient,,,1.17,0.76,,0.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.31,1.11,
NF-CLOBETASOL PROPIONATE CRM 0.05%,402177,CDM,637,RC,,,outpatient,,,22.95,14.92,,15.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.66,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.14,21.8,
NF-NOVOLOG MIX 70/30 FLEXPEN SUBQ SUSP,402178,CDM,637,RC,,,outpatient,,,109.7,71.31,,73.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,98.73,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,87.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.28,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.22,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,65.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.37,104.22,
NF-HUMALOG KWIKPEN SUBQ SUSP 100U/1ML,402179,CDM,637,RC,,,outpatient,,,109.84,71.4,,73.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,98.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,87.87,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,65.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.4,104.35,
NF-REYATAZ CAP 300MG,402180,CDM,637,RC,,,outpatient,,,197.69,128.5,,132.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,55.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,177.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,158.15,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,148.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,187.81,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,168.04,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,118.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.92,187.81,
NF-BYSTOLIC 5MG ORAL TABLET,402181,CDM,637,RC,,,outpatient,,,12.3,8,,8.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.29,11.69,
NF-LISINOPRIL ORAL TABLET 20MG,402182,CDM,637,RC,,,outpatient,,,3.13,2.03,,2.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.84,2.97,
NF-ONDANSETRON HCL TAB 4MG,402183,CDM,637,RC,,,outpatient,,,92.7,60.26,,62.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,83.43,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,74.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,78.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.82,88.07,
NF-MAGNESIUM OXIDE TABLET 420MG,402184,CDM,637,RC,,,outpatient,,,0.33,0.21,,0.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.09,0.31,
"LIDOCAINE 1% WITH EPI 1:100,000 INJ 20ML",402186,CDM,250,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
NF-LUTEIN LIQUID FILLED CAPSULE 20MG,402187,CDM,637,RC,,,outpatient,,,0.97,0.63,,0.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.87,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.73,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.92,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.26,0.92,
NF-MIRALAX PWD FOR SOLN 17GM/DOSE,402188,CDM,637,RC,,,outpatient,,,0.3,0.2,,0.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.08,0.29,
NF-GABAPENTIN ORAL TABLET 600MG,402189,CDM,637,RC,,,outpatient,,,7.58,4.93,,5.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.03,7.2,
NF-SERTRALINE HCL TAB 100MG,402190,CDM,637,RC,,,outpatient,,,11.16,7.25,,7.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.93,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.49,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.99,10.6,
NF-CYCLOBENZAPRINE HCL ORAL TABLET 5MG,402191,CDM,637,RC,,,outpatient,,,4.92,3.2,,3.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.43,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.32,4.67,
NF-BETAMETHASONE CRM 0.1%,402192,CDM,637,RC,,,outpatient,,,1.02,0.66,,0.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.77,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.97,
NF-TANZEUM SUBCUTANEOUS PWD FOR SOLN 30M,402193,CDM,637,RC,,,outpatient,,,366.14,237.99,,245.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,102.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,102.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,267.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,329.53,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,101.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,292.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,274.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,103.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,98.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,102.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,347.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,99.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,311.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,219.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,219.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,98.02,347.83,
NF-IRBESARTAN ORAL TABLET 150MG,402194,CDM,637,RC,,,outpatient,,,9.22,5.99,,6.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.92,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.47,8.76,
NF-VITAMIN B COMPLEX TAB,402196,CDM,637,RC,,,outpatient,,,1.59,1.03,,1.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.43,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.27,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,1.51,
NF-HYDROXYUREA CAP 500MG,402197,CDM,637,RC,,,outpatient,,,4.42,2.87,,2.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.76,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.18,4.2,
NF-ELIQUIS ORAL TABLET 5MG,402198,CDM,250,RC,,,outpatient,,,20.01,13.01,,13.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.01,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.36,19.01,
NF-CYPROHEPTADINE HCL ORAL TABLET 4MG,402200,CDM,637,RC,,,outpatient,,,1.91,1.24,,1.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.53,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.81,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.51,1.81,
NF-INDAPAMIDE TAB 1.25MG,402201,CDM,637,RC,,,outpatient,,,0.69,0.45,,0.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.55,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.52,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.18,0.66,
NF-PRESERVISION AREDS LIQUID FILLED CAPS,402202,CDM,637,RC,,,outpatient,,,0.68,0.44,,0.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.61,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.51,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.18,0.65,
NF-ATORVASTATIN CALCIUM ORAL TAB 20MG,402205,CDM,637,RC,,,outpatient,,,42.2,27.43,,28.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.3,40.09,
NF-SERTRALINE HCL ORAL TABLET 25MG,402206,CDM,637,RC,,,outpatient,,,8.54,5.55,,5.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.29,8.11,
NF-LOSARTAN POTASSIUM ORAL TAB 100MG,402207,CDM,637,RC,,,outpatient,,,9.25,6.01,,6.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.33,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.79,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.48,8.79,
NF-DIPHENHYDRAMINE CAP 25MG,402208,CDM,637,RC,,,outpatient,,,2.46,1.6,,1.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.66,2.34,
NF-SYNTHROID 112MCG ORAL TABLET,402209,CDM,637,RC,,,outpatient,,,3.28,2.13,,2.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.46,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.88,3.12,
NF-NUCYNTA ORAL TABLET 50MG,402210,CDM,637,RC,,,outpatient,,,15.75,10.24,,10.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.22,14.96,
NF-DIPHENHYDRAMINE HCL CAP 25MG,402211,CDM,637,RC,,,outpatient,,,0.3,0.2,,0.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.08,0.29,
NF-ZAFIRLUKAST ORAL TABLET 20MG,402212,CDM,637,RC,,,outpatient,,,5.37,3.49,,3.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.83,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.44,5.1,
NF-GABAPENTIN TAB 800MG,402213,CDM,637,RC,,,outpatient,,,12.4,8.06,,8.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.47,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.32,11.78,
NF-IPRATROPIUM BROMIDE INH SOLN 0.02%,402215,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MORPHINE SULFATE INJ: 4MG/1ML,402216,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-CELEBREX CAP 200MG,402217,CDM,637,RC,,,outpatient,,,24.49,15.92,,16.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.59,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.56,23.27,
NF-LINZESS CAP 145MCG,402218,CDM,637,RC,,,outpatient,,,36.54,23.75,,24.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.78,34.71,
NF-PIOGLITAZONE HCL ORAL TABLET 15MG,402219,CDM,637,RC,,,outpatient,,,21.04,13.68,,14.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.63,19.99,
NF-INDAPAMIDE ORAL TABLET 2.5MG,402220,CDM,637,RC,,,outpatient,,,4.65,3.02,,3.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.19,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.24,4.42,
NF-DEMEROL HYDROCHLORIDE TABLET 50MG,402221,CDM,637,RC,,,outpatient,,,5.49,3.57,,3.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.39,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.22,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,5.22,
BENZOIN COMPOUND TINCTURE 2 OZ,402223,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-ABILIFY 5MG ORAL TABLET,402224,CDM,637,RC,,,outpatient,,,183.25,119.11,,122.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,164.93,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,51.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,146.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,137.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,49.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,174.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,50.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.76,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.06,174.09,
NF-GENTEAL OPHTHALMIC GEL 0.3%,402226,CDM,637,RC,,,outpatient,,,2.16,1.4,,1.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.73,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.62,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.58,2.05,
NF-MORPHINE SULFATE ORAL TAB ER 60MG,402228,CDM,637,RC,,,outpatient,,,7.49,4.87,,5.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.62,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.01,7.12,
NF-MEDROXYPROGESTERONE ACETATE TAB 2.5MG,402230,CDM,637,RC,,,outpatient,,,0.94,0.61,,0.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.75,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.71,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.89,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.25,0.89,
NF-ESTRADIOL ORAL TABLET 0.5MG,402231,CDM,637,RC,,,outpatient,,,0.66,0.43,,0.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.53,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.18,0.63,
NF-ENTRESTO ORAL TABLET 24MG-26MG,402232,CDM,637,RC,,,outpatient,,,22.5,14.63,,15.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.02,21.38,
NF-ENTRESTO ORAL TABLET 24MG-26MG,402233,CDM,637,RC,,,outpatient,,,22.5,14.63,,15.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.02,21.38,
NF-TRULICITY SUBQ SOLN 0.75MG/0.5ML,402235,CDM,637,RC,,,outpatient,,,1034.64,672.52,,693.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,289.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,276.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,289.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,755.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,931.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,288.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,827.71,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,775.98,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,292.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,276.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,289.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,982.91,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,282.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,879.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,620.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,289.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,620.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,276.97,982.91,
NF-ELIQUIS ORAL TABLET 5MG,402236,CDM,637,RC,,,outpatient,,,21.59,14.03,,14.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.43,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.27,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.78,20.51,
NF-VANCOMYCIN HCL CAP 125MG,402237,CDM,637,RC,,,outpatient,,,93.98,61.09,,62.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,84.58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,75.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,70.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,56.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.16,89.28,
NF-MORPHINE SULFATE ORAL TAB ER 30MG,402238,CDM,637,RC,,,outpatient,,,7.64,4.97,,5.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.11,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.73,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.49,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.05,7.26,
NF-PRISTIQ EXTENDED-RELEASE TABLET 100MG,402239,CDM,637,RC,,,outpatient,,,33.28,21.63,,22.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.96,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.91,31.62,
NF-FENOFIBRATE CAP 134MG,402240,CDM,637,RC,,,outpatient,,,5.88,3.82,,3.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.29,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.57,5.59,
NF-ZETIA TAB 10MG,402241,CDM,637,RC,,,outpatient,,,31.2,20.28,,20.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.35,29.64,
NF-AMANTADINE HCL CAPSULE 100MG,402242,CDM,637,RC,,,outpatient,,,3.88,2.52,,2.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.49,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.91,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.04,3.69,
NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG,402243,CDM,637,RC,,,outpatient,,,89.91,58.44,,60.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,80.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,71.93,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,53.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.07,85.41,
NF-XARELTO 15MG ORAL TABLET,402244,CDM,637,RC,,,outpatient,,,43.15,28.05,,28.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.55,40.99,
LIDOCAINE 2% (20 MG/ML) INJECTION PF,402245,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
BENZOCAINE/MENTHOL 15MG/2.3MG LOZENGE,402246,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-APTIOM 800MG ORAL TABLET,402251,CDM,637,RC,,,outpatient,,,91.15,59.25,,61.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,82.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.4,86.59,
NF-APTIOM ORAL TABLET 600MG,402252,CDM,637,RC,,,outpatient,,,91.15,59.25,,61.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,82.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.4,86.59,
NF-OXYCONTIN EXTENDED RELEASE TABLET 60M,402253,CDM,637,RC,,,outpatient,,,40.41,26.27,,27.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.33,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.31,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.39,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.82,38.39,
NF-MELATONIN EXTRA STRENGTH TABLET,402254,CDM,637,RC,,,outpatient,,,0.39,0.25,,0.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.31,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.1,0.37,
NF-FLECAINIDE ACETATE ORAL TABLET 100MG,402255,CDM,637,RC,,,outpatient,,,12.04,7.83,,8.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.22,11.44,
NF-LAMOTRIGINE ORAL TABLET 200MG,402256,CDM,637,RC,,,outpatient,,,17.01,11.06,,11.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.31,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.61,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.16,
NF-GLYCERIN RECTAL SUPP,402257,CDM,637,RC,,,outpatient,,,1.94,1.26,,1.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.55,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.46,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.52,1.84,
NF-PRENATAL VITAMIN ORAL TABLET,402258,CDM,637,RC,,,outpatient,,,0.8,0.52,,0.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.21,0.76,
NF-LEVALBUTEROL HCL INH SOLUTION 1.25MG/,402259,CDM,637,RC,,,outpatient,,,6.71,4.36,,4.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.8,6.37,
NF-OXAZEPAM CAP 15MG,402260,CDM,637,RC,,,outpatient,,,4.95,3.22,,3.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.71,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.33,4.7,
NF-IMIPRAMINE HCL ORAL TABLET 50MG,402261,CDM,637,RC,,,outpatient,,,0.92,0.6,,0.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.83,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.87,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.25,0.87,
NF-OXAZEPAM CAP 15MG,402262,CDM,637,RC,,,outpatient,,,4.53,2.94,,3.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.21,4.3,
NF-OXAZEPAM CAP 15MG,402263,CDM,637,RC,,,outpatient,,,3.3,2.15,,2.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.88,3.14,
NF-OXAZEPAM CAP 15MG,402264,CDM,637,RC,,,outpatient,,,3.27,2.13,,2.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.88,3.11,
NF-AMANTADINE HCL 100MG ORAL CAPSULE,402265,CDM,637,RC,,,outpatient,,,1.1,0.72,,0.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.99,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.94,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.29,1.05,
NF-RAMIPRIL CAP 10MG,402266,CDM,637,RC,,,outpatient,,,9.72,6.32,,6.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.6,9.23,
NF-LACOSAMIDE SOLN 10MG/1ML,402267,CDM,637,RC,,,outpatient,,,4.4,2.86,,2.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.74,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.18,4.18,
NF-COLESTIPOL HCL PWD FOR SUSP 5GM/1PACK,402268,CDM,637,RC,,,outpatient,,,18.44,11.99,,12.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.75,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.94,17.52,
NF-OPIUM ORAL TINCTURE 10MG/1ML,402269,CDM,637,RC,,,outpatient,,,2.71,1.76,,1.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.73,2.57,
NF-MEGACE ES ORAL SUSPENSION 625MG/5ML,402270,CDM,637,RC,,,outpatient,,,21.95,14.27,,14.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.46,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.88,20.85,
NF-PROPRANOLOL HCL TAB 10MG,402272,CDM,637,RC,,,outpatient,,,0.61,0.4,,0.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.46,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.16,0.58,
NF-ALENDRONATE SOD ORAL TABLET 70MG,402273,CDM,637,RC,,,outpatient,,,57.98,37.69,,38.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.52,55.08,
NF-AMITRIPTYLINE-CHLORDIAZEPOXIDE TAB 12,402274,CDM,637,RC,,,outpatient,,,4.6,2.99,,3.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.91,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.23,4.37,
NF-XENAZINE 12.5MG ORAL TABLET,402275,CDM,637,RC,,,outpatient,,,341.42,221.92,,228.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,95.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,95.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,249.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,307.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,95.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,273.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,256.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,96.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,91.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,95.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,324.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,93.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,290.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,204.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,204.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,91.4,324.35,
NF-XENAZINE ORAL TABLET 25MG,402276,CDM,637,RC,,,outpatient,,,682.84,443.85,,457.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,191.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,182.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,191.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,498.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,614.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,190.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,546.27,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,512.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,193.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,182.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,191.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,648.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,186.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,580.41,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,409.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,191.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,409.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,182.8,648.7,
NF-PRIMIDONE ORAL TABLET 250MG,402277,CDM,637,RC,,,outpatient,,,5.77,3.75,,3.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.19,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.54,5.48,
NF-MYRBETRIQ ORAL TABLET 50MG,402278,CDM,637,RC,,,outpatient,,,35.61,23.15,,23.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.71,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.53,33.83,
NF-ASTELIN READY-SPRAY NASAL,402279,CDM,637,RC,,,outpatient,,,14.85,9.65,,9.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.98,14.11,
NF-FISH OIL CAPSULE 1000MG,402280,CDM,637,RC,,,outpatient,,,0.21,0.14,,0.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.19,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,0.2,
NF-VERAMYST NASAL SPRAY 27.5MCG/1 ACT,402281,CDM,637,RC,,,outpatient,,,67.91,44.14,,45.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.33,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,50.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.72,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.18,64.51,
NF-GLUCOSAMINE & CHONDR CAP 500MG-400MG,402282,CDM,637,RC,,,outpatient,,,1.92,1.25,,1.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.73,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.51,1.82,
NF-CO-Q10 TABLET 60MG,402283,CDM,637,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-PROLENSA 0.07% OPHTHALMIC SOLUTION,402284,CDM,637,RC,,,outpatient,,,264.69,172.05,,177.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,74.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,193.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,238.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,73.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,211.75,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,198.52,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,72.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,224.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,158.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,158.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.86,251.46,
NF-GATIFLOXACIN 0.5% OPHTHALMIC SOLUTION,402285,CDM,637,RC,,,outpatient,,,141.79,92.16,,95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,127.61,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,113.43,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,106.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,120.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.96,134.7,
NF-BISOPROLOL FUMARATE/HYDROCHLOROTHIAZI,402286,CDM,637,RC,,,outpatient,,,3.38,2.2,,2.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.9,3.21,
NF-MELATONIN 3MG,402287,CDM,637,RC,,,outpatient,,,0.11,0.07,,0.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.03,0.1,
NF-TEGRETOL TAB 200MG,402288,CDM,637,RC,,,outpatient,,,6.27,4.08,,4.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.68,5.96,
NF-LAMOTRIGINE DISINTEGRATING TABLET 100,402289,CDM,637,RC,,,outpatient,,,30.41,19.77,,20.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.33,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.89,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.14,28.89,
NF-SULFAZINE TABLET 500MG,402290,CDM,637,RC,,,outpatient,,,0.7,0.46,,0.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.19,0.67,
NF-PREMARIN ORAL TABLET 1.25MG,402292,CDM,637,RC,,,outpatient,,,5.92,3.85,,3.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.33,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.74,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.58,5.62,
LACTOBACILLUS (CULTURELLE) CAPSULE,402293,CDM,250,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
POTASSIUM CL SPRINKLE CAPSULES: 10 MEQ,402294,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-NAMENDA XR CAP ER 28MG,402296,CDM,637,RC,,,outpatient,,,42.48,27.61,,28.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.86,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.36,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.37,40.36,
NF-CHLORPROMAZINE HCL TAB 10MG,402298,CDM,637,RC,,,outpatient,,,2.1,1.37,,1.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.56,2,
NF-CHLORPROMAZINE HCL TAB 25MG,402299,CDM,637,RC,,,outpatient,,,1.74,1.13,,1.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.57,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.39,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.31,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.47,1.65,
NF-KETOROLAC TROMETHAMINE 0.4% OPHTHALMI,402300,CDM,637,RC,,,outpatient,,,63.3,41.15,,42.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,56.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.95,60.14,
NF-VALTREX ORAL TABLET 500MG,402301,CDM,637,RC,,,outpatient,,,25.47,16.56,,17.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.82,24.2,
NF-MYSOLINE TAB 50MG,402302,CDM,637,RC,,,outpatient,,,1.72,1.12,,1.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.46,1.63,
NF-PERCOCET ORAL TABLET 10MG-325MG,402303,CDM,637,RC,,,outpatient,,,57.88,37.62,,38.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.09,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.49,54.99,
NF-KETOROLAC TROMETHAMINE 15MG/1ML,402304,CDM,637,RC,,,outpatient,,,3.82,2.48,,2.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.02,3.63,
NF-MIDODRINE HCL ORAL TABLET 5MG,402306,CDM,637,RC,,,outpatient,,,7.25,4.71,,4.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.53,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.89,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.94,6.89,
NF-MIDODRINE HCL ORAL TABLET 10MG,402307,CDM,637,RC,,,outpatient,,,14.51,9.43,,9.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.61,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.88,13.78,
"NF-ADDERALL XR 30MG ORAL CAPSULE, EXTEND",402309,CDM,637,RC,,,outpatient,,,17.37,11.29,,11.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.9,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.76,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.65,16.5,
NF-ANASTROZOLE 1MG ORAL TABLET,402310,CDM,637,RC,,,outpatient,,,2.75,1.79,,1.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.74,2.61,
NF-ANASTROZOLE 1MG ORAL TABLET,402311,CDM,637,RC,,,outpatient,,,39.84,25.9,,26.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.87,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.67,37.85,
NF-HYDROCHLOROTHIAZIDE CAP 12.5MG,402312,CDM,637,RC,,,outpatient,,,1.27,0.83,,0.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.34,1.21,
NF-PROBIOTIC FORMULA CAP 250MG-1BILLION,402313,CDM,637,RC,,,outpatient,,,1.91,1.24,,1.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.53,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.81,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.51,1.81,
NF-GABAPENTIN ORAL TABLET 600MG,402314,CDM,637,RC,,,outpatient,,,12.06,7.84,,8.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.65,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.23,11.46,
NF-ZALEPLON CAP 5MG,402315,CDM,637,RC,,,outpatient,,,9.11,5.92,,6.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.29,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.74,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.44,8.65,
PHENYLEPRINE 0.25% NASAL SPRAY 15 mL,402317,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-BETOPTIC S 0.25% OPHTHALMIC SUSPENSIO,402318,CDM,637,RC,,,outpatient,,,98.15,63.8,,65.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.27,93.24,
NF-ERYTHROMYCIN OPHTHALMIC OINTMENT 5MG/,402319,CDM,637,RC,,,outpatient,,,8.79,5.71,,5.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.91,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.35,8.35,
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,402320,CDM,637,RC,,,outpatient,,,78.16,50.8,,52.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,70.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,62.53,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,58.62,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,66.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,46.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.92,74.25,
NF-BUSPIRONE HCL ORAL TABLET 10MG,402321,CDM,637,RC,,,outpatient,,,4.04,2.63,,2.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.08,3.84,
NF-DONNATAL TAB,402324,CDM,637,RC,,,outpatient,,,32.05,20.83,,21.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.58,30.45,
NF-DONNATAL TABLET,402326,CDM,637,RC,,,outpatient,,,46.02,29.91,,30.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.42,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.52,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.32,43.72,
NF-MELOXICAM ORAL TABLET 15MG,402327,CDM,637,RC,,,outpatient,,,15.17,9.86,,10.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.06,14.41,
NF-VALSARTAN AND HYDROCHLOROTHIAZIDE TAB,402328,CDM,637,RC,,,outpatient,,,11.8,7.67,,7.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.16,11.21,
NF-ROSUVASTATIN CALCIUM ORAL TABLET 20MG,402329,CDM,637,RC,,,outpatient,,,26.83,17.44,,17.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.18,25.49,
NF-SPIRIVA RESPIMAT INH SPRAY 2.5MCG/1AC,402330,CDM,637,RC,,,outpatient,,,306.84,199.45,,205.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,85.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,223.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,276.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,85.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,245.47,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,230.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,86.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,82.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,83.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,260.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,184.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,184.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,82.14,291.5,
NF-MIRALAX ORAL PWD FOR SOLN 17GM/1DOSE,402331,CDM,637,RC,,,outpatient,,,0.09,0.06,,0.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.09,
NF-DEXILANT CAP DR 60MG,402332,CDM,637,RC,,,outpatient,,,13.14,8.54,,8.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.83,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.51,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.86,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.52,12.48,
NF-ROSUVASTATIN CALCIUM ORAL TABLET 20MG,402333,CDM,637,RC,,,outpatient,,,26.84,17.45,,17.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.47,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.19,25.5,
NF-MELOXICAM ORAL TABLET 15MG,402334,CDM,637,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
NF-DALIRESP ORAL TABLET 500MCG,402335,CDM,637,RC,,,outpatient,,,35.42,23.02,,23.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.48,33.65,
NF-ABREVA TOPICAL CREAM 10%,402336,CDM,637,RC,,,outpatient,,,27.83,18.09,,18.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.45,26.44,
NF-DAPTOMYCIN IV PWD FOR SOLN 500MG,402338,CDM,637,RC,,,outpatient,,,706,458.9,,473.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,197.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,189,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,197.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,515.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,635.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,196.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,564.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,529.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,199.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,189,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,197.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,670.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,192.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,600.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,423.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,423.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,189,670.7,
NF-DONNATAL ELIX,402339,CDM,637,RC,,,outpatient,,,10.67,6.94,,7.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.86,10.14,
NF-DONNATAL TAB,402341,CDM,637,RC,,,outpatient,,,34.21,22.24,,22.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.79,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.16,32.5,
NF-LEVOTHYROXINE SODIUM ORAL TABLET 175M,402342,CDM,637,RC,,,outpatient,,,2.42,1.57,,1.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.82,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.65,2.3,
NF-TORSEMIDE ORAL TABLET 100MG,402343,CDM,637,RC,,,outpatient,,,9.12,5.93,,6.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.44,8.66,
NF-BENEFIBER FIBER DRINK MIX ORAL PACKET,402344,CDM,637,RC,,,outpatient,,,1.06,0.69,,0.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.85,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.28,1.01,
NF-AMITRIPTYLINE HCL ORAL TABLET 25MG,402347,CDM,637,RC,,,outpatient,,,1.91,1.24,,1.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.53,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.81,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.51,1.81,
NF-POTASSIUM CHLORIDE ORAL TAB ER 10MEQ,402348,CDM,637,RC,,,outpatient,,,1.17,0.76,,0.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.31,1.11,
NF-ACETAMINOPHEN CAP 500MG,402349,CDM,637,RC,,,outpatient,,,0.06,0.04,,0.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.05,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.06,
NF-PHILLIPS' ORAL TABLET 500MG,402350,CDM,637,RC,,,outpatient,,,0.55,0.36,,0.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.15,0.52,
"BUPIVACAINE 0.25% W/EPI 1:200,000 INJ",402351,CDM,250,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
NF-MIDODRINE HCL ORAL TABLET 5MG,402352,CDM,637,RC,,,outpatient,,,7.25,4.71,,4.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.53,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.89,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.94,6.89,
NF-PEDIAPRED ORAL SOLUTION 5MG/5ML,402353,CDM,637,RC,,,outpatient,,,4.97,3.23,,3.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.73,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.33,4.72,
NF-TYLENOL EXTRA STRENGTH SOLN 500MG/15M,402354,CDM,637,RC,,,outpatient,,,0.07,0.05,,0.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.07,
NF-LOPERAMIDE HCL ORAL SUSPENSION 1MG/7.,402355,CDM,637,RC,,,outpatient,,,0.8,0.52,,0.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.21,0.76,
NF-GLUCERNA 1.5 CAL ORAL SOLUTION,402356,CDM,637,RC,,,outpatient,,,0.04,0.03,,0.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.01,0.04,
NF-FLECAINIDE ACETATE ORAL TABLET 50MG,402357,CDM,637,RC,,,outpatient,,,7.68,4.99,,5.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.91,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.76,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.06,7.3,
NF-FENOFIBRATE CAP 150MG,402359,CDM,637,RC,,,outpatient,,,21.47,13.96,,14.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.75,20.4,
PHENYLEPHRINE 10MG/ML INJ  1 ML VIAL *OR,402360,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-ESTRACE ORAL TABLET 1MG,402361,CDM,637,RC,,,outpatient,,,2.75,1.79,,1.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.74,2.61,
NF-PRIMIDONE ORAL TABLET 50MG,402364,CDM,637,RC,,,outpatient,,,1.34,0.87,,0.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.36,1.27,
NF-BYSTOLIC 2.5MG ORAL TABLET,402365,CDM,637,RC,,,outpatient,,,14.61,9.5,,9.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.69,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.96,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.91,13.88,
NF-VITAMIN D3 1000IU ORAL TABLET,402366,CDM,637,RC,,,outpatient,,,0.08,0.05,,0.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.07,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.06,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.08,
"NF-NIFEDIPINE 30MG ORAL TABLET, EXTENDED",402367,CDM,637,RC,,,outpatient,,,3.93,2.55,,2.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.05,3.73,
NF-NAPROXEN ORAL TABLET 220MG,402368,CDM,637,RC,,,outpatient,,,2.86,1.86,,1.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.57,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.29,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,2.72,
NF-ALPHAGAN P 0.15% OPHTHALMIC SOLUTION,402369,CDM,637,RC,,,outpatient,,,52.41,34.07,,35.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.93,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.31,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.79,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.03,49.79,
NF-NIFEdipine Tablet Extended-Release 90,402370,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
NF-ALLEGRA ALLERGY ORAL TABLET 180MG,402371,CDM,637,RC,,,outpatient,,,1.64,1.07,,1.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.31,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.39,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.44,1.56,
NF-ALLERGY RELIEF ORAL TABLET 180MG,402372,CDM,637,RC,,,outpatient,,,1.14,0.74,,0.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.03,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.86,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.31,1.08,
NF-Theophylline Oral 12 Hr Tab ER 300MG,402373,CDM,637,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Pentoxifylline Tablet 400MG,402375,CDM,637,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Symbicort Inh Aer Liq 160MCG-4.5MCG,402376,CDM,637,RC,,,outpatient,,,108,70.2,,72.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,97.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,86.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,91.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.91,102.6,
NF-Doxepin Oral Capsule 25MG,402377,CDM,637,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Zonisamide Oral Capsule 50MG,402379,CDM,637,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-ZONISAMIDE CAP 100MG,402380,CDM,637,RC,,,outpatient,,,16.3,10.6,,10.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.67,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.36,15.49,
NF-CLONIDINE TD PATCH ER 0.3MG/24HR,402383,CDM,637,RC,,,outpatient,,,483.47,314.26,,323.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,135.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,135.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,352.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,435.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,134.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,386.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,362.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,136.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,129.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,135.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,459.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,132.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,410.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,290.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,290.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,129.42,459.3,
NF-busPIRone Oral Tablet 10MG,402384,CDM,637,RC,,,outpatient,,,5,3.25,,3.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,4.75,
NF-Revlimid Oral Capsule 5MG,402385,CDM,637,RC,,,outpatient,,,2149,1396.85,,1439.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,601.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,575.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,601.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1568.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1934.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,598.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1719.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1611.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,607.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,575.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,601.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2041.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,586.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1826.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1289.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,601.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1289.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,586.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.29,2041.55,
"NF-NIFEdipine Tablet, Extended-Release 3",402386,CDM,637,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-NIFEDIPINE ER TABLET 60MG,402387,CDM,637,RC,,,outpatient,,,6.94,4.51,,4.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.55,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.86,6.59,
NF-SENNA CONCENTRATE ORAL TABLET 8.6MG,402388,CDM,637,RC,,,outpatient,,,0.45,0.29,,0.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.41,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.12,0.43,
NF-Xarelto Oral Tablet 20MG,402389,CDM,637,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-ELIQUIS ORAL TABLET 5MG,402390,CDM,637,RC,,,outpatient,,,23.3,15.15,,15.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.24,22.14,
NF-EXELON CAP 3MG,402391,CDM,637,RC,,,outpatient,,,20.67,13.44,,13.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.57,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,19.64,
NF-Xarelto Oral Tablet 10MG,402392,CDM,637,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-INVEGA TAB ER 3MG,402393,CDM,637,RC,,,outpatient,,,122.06,79.34,,81.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,34.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,109.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,97.65,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,91.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,103.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,73.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.68,115.96,
NF-LATUDA ORAL TABLET 20MG,402394,CDM,637,RC,,,outpatient,,,133.6,86.84,,89.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,120.24,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,100.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.92,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.76,126.92,
NF-METHADONE HCL ORAL TABLET 5MG,402398,CDM,637,RC,,,outpatient,,,0.96,0.62,,0.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.77,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.91,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.26,0.91,
NF-NORTRIPTYLINE HCL CAP 50MG,402399,CDM,637,RC,,,outpatient,,,0.67,0.44,,0.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.57,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.18,0.64,
NF-TraZODone HCl Oral Tablet 50MG,402400,CDM,637,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-ANASTROZOLE ORAL TABLET 1MG,402404,CDM,637,RC,,,outpatient,,,39.91,25.94,,26.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.93,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.91,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.68,37.91,
NF-ELIQUIS TAB 2.5MG,402405,CDM,637,RC,,,outpatient,,,23.3,15.15,,15.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.24,22.14,
NF-Propafenone HCl Tablet 150MG,402407,CDM,637,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Xarelto Oral Tablet 15MG,402409,CDM,637,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-Namenda XR Oral Capsule ER 14MG,402410,CDM,637,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-Eliquis Oral Tablet 5MG,402411,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-Eliquis Oral Tablet 5MG,402412,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-Verapamil HCl Tablet 240MG,402413,CDM,637,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Coumadin Tablet 4MG,402414,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
NF-Verapamil Hydrochloride Oral Tab 120M,402415,CDM,637,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
NF-Tamoxifen Citrate Tab 20MG,402416,CDM,637,RC,,,outpatient,,,11,7.15,,7.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.94,10.45,
NF-Eliquis Oral Tablet 5MG,402417,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-busPIRone HCl Tablet 10MG,402418,CDM,637,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-DOXEPIN HCL CAP 10MG,402420,CDM,637,RC,,,outpatient,,,0.61,0.4,,0.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.46,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.16,0.58,
NF-Tamoxifen Citrate Tab 20MG,402421,CDM,637,RC,,,outpatient,,,11,7.15,,7.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.94,10.45,
NF-TAMOXIFEN CITRATE ORAL TABLET 20MG,402423,CDM,637,RC,,,outpatient,,,2.55,1.66,,1.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.91,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.68,2.42,
NF-Anoro Ellipta Inhalation Powder,402424,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
NF-FLECAINIDE ACETATE ORAL TABLET 100MG,402425,CDM,637,RC,,,outpatient,,,12.04,7.83,,8.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.22,11.44,
NF-XARELTO ORAL TABLET 20MG,402426,CDM,637,RC,,,outpatient,,,46.56,30.26,,31.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,37.25,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.92,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.46,44.23,
NF-Creon Oral Cap DR 3000U-9500U-15000U,402427,CDM,637,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-CELEBREX CAP 100MG,402428,CDM,637,RC,,,outpatient,,,24.18,15.72,,16.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.47,22.97,
NF-Anagrelide Hydrochloride Capsule 0.5M,402429,CDM,637,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
NF-Xarelto Oral Tablet 15MG,402430,CDM,637,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-Flecainide Acetate Tablet 100MG,402432,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-Xarelto Oral Tablet 20MG,402433,CDM,637,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-Naltrexone Oral Tablet 50MG,402434,CDM,637,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
NF-Eliquis Oral Tablet 5MG,402435,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-Inderal LA Oral Cap ER 60MG,402436,CDM,637,RC,,,outpatient,,,64,41.6,,42.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.13,60.8,
NF-BUMETANIDE ORAL TABLET 1MG,402438,CDM,637,RC,,,outpatient,,,1.5,0.98,,1.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.4,1.43,
NF-BUMETANIDE ORAL TABLET 1MG,402439,CDM,637,RC,,,outpatient,,,1.5,0.98,,1.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.4,1.43,
NF-Lumigan Ophth Solution 0.01%,402440,CDM,637,RC,,,outpatient,,,236,153.4,,158.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,66.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,212.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,65.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,188.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,177,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,66.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,63.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,224.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,200.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,141.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.18,224.2,
NF-Butrans Transdermal Patch ER 10MCG/1H,402441,CDM,637,RC,,,outpatient,,,330,214.5,,221.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,92.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,240.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,297,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,91.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,264,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,247.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,93.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,88.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,313.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,90.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,280.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,198,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,198,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,88.34,313.5,
NF-Adempas Oral Tablet 2.5MG,402442,CDM,637,RC,,,outpatient,,,368,239.2,,246.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,331.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,102.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,294.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,276,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,104.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,98.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,349.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,100.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,312.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,220.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,220.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,98.51,349.6,
NF-Letairis Oral Tablet 5MG,402443,CDM,637,RC,,,outpatient,,,1110,721.5,,743.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,297.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,810.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,999,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,309.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,888,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,832.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,313.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,297.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1054.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,303.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,943.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,666,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,666,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,303.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,297.15,1054.5,
NF-Prolensa Ophthalmic Solution 0.07%,402444,CDM,637,RC,,,outpatient,,,276,179.4,,184.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,77.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,201.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,248.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,76.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,220.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,207,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,78.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,73.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,262.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,75.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,234.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,165.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,165.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.89,262.2,
NF-Eliquis Oral Tablet 5MG,402445,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-ELIQUIS ORAL TABLET 5MG,402446,CDM,637,RC,,,outpatient,,,23.3,15.15,,15.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.24,22.14,
NF-Xarelto Oral Tablet 15MG,402447,CDM,637,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-Amantadine HCl Oral Capsule 100MG,402448,CDM,637,RC,,,outpatient,,,5,3.25,,3.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,4.75,
NF-LOTREL CAP 5MG-20MG,402449,CDM,637,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,402450,CDM,637,RC,,,outpatient,,,19.3,12.55,,12.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.41,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.17,18.34,
NF-BREO ELLIPTA INHALATION POWDER,402451,CDM,637,RC,,,outpatient,,,19.3,12.55,,12.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.41,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.17,18.34,
NF-Breo Ellipta Inh Pwd 100MCG/1Actuatio,402452,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
NF-Restasis Ophthalmic Emulsion 0.05%,402453,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-Clobetasol Prop Topical Ointment 0.05,402455,CDM,637,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
NF-Eliquis Oral Tablet 2.5MG,402456,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-Anagrelide Hydrochloride Capsule 0.5M,402460,CDM,637,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
NF-Memantine HCl Oral Tablet 5MG,402461,CDM,637,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
NF-Eliquis Oral Tablet 5MG,402462,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-Xifaxan Oral Tablet 550MG,402463,CDM,637,RC,,,outpatient,,,120,78,,80.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,108,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.12,114,
THERAHONEY GEL 0.5 OZ,402464,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-METHOTREXATE ORAL TABLET 2.5MG,402466,CDM,637,RC,,,outpatient,,,15.99,10.39,,10.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.79,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.28,15.19,
NF-Letairis Oral Tablet 5MG,402467,CDM,637,RC,,,outpatient,,,1110,721.5,,743.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,297.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,810.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,999,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,309.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,888,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,832.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,313.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,297.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1054.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,303.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,943.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,666,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,666,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,303.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,297.15,1054.5,
NF-ILEVRO OPHTH SUSP 0.3%,402468,CDM,637,RC,,,outpatient,,,523.66,340.38,,350.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,146.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,146.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,382.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,471.29,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,145.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,418.93,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,392.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,148.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,140.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,146.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,497.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,142.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,445.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,314.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,146.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,314.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.18,497.48,
NF-JANUVIA ORAL TABLET 100MG,402469,CDM,637,RC,,,outpatient,,,47.74,31.03,,31.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,42.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.19,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,35.81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.78,45.35,
NF-OXAZEPAM CAP 15MG,402471,CDM,637,RC,,,outpatient,,,4.36,2.83,,2.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.49,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.17,4.14,
NF-Casodex Tablet 50MG,402472,CDM,637,RC,,,outpatient,,,63,40.95,,42.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,56.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.87,59.85,
NF-IRBESARTAN ORAL TABLET 150MG,402476,CDM,637,RC,,,outpatient,,,9.21,5.99,,6.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.29,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.91,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.47,8.75,
NF-Eliquis Oral Tablet 5MG,402477,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-DULERA INH AER PWD 5MCG-200MCG/ACT,402479,CDM,637,RC,,,outpatient,,,80.46,52.3,,53.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72.41,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64.37,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.39,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.54,76.44,
NF-Alfuzosin Hydrochloride Oral Tab ER 1,402480,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-Stiolto Respimat Inh 2.5-2.5MCG/1Act,402481,CDM,637,RC,,,outpatient,,,306,198.9,,205.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,85.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,223.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,275.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,85.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,244.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,229.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,86.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,81.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,290.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,83.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,260.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,183.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,183.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.92,290.7,
NF-Nortriptyline Hydrochloride Cap 50MG,402482,CDM,637,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
NF-ADEMPAS ORAL TABLET 2.5MG,402483,CDM,637,RC,,,outpatient,,,390.11,253.57,,261.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,284.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,351.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,108.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,312.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,292.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,110.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,104.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,370.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,106.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,331.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,234.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.43,370.6,
GENTAMICIN SULF 0.1% OINTMENT,402487,CDM,250,RC,,,outpatient,,,91,59.15,,60.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.36,86.45,
NF-Flecainide Acetate Tablet 100MG,402488,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-Xarelto Oral Tablet 20MG,402489,CDM,637,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-BUSPIRONE HCL ORAL TABLET 15MG,402491,CDM,637,RC,,,outpatient,,,5.97,3.88,,4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.6,5.67,
NF-GEMFIBROZIL ORAL TABLET 600MG,402492,CDM,637,RC,,,outpatient,,,3.56,2.31,,2.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.85,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.95,3.38,
NF-Potassium Chloride Oral Tab ER 20MEQ,402493,CDM,637,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Soma Tablet 350MG,402494,CDM,637,RC,,,outpatient,,,34,22.1,,22.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,32.3,
NF-Sildenafil Oral Tablet 20MG,402495,CDM,637,RC,,,outpatient,,,63,40.95,,42.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,56.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.87,59.85,
NF-LUNESTA ORAL TABLET 2MG,402496,CDM,637,RC,,,outpatient,,,21.52,13.99,,14.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.29,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.76,20.44,
NF-SITAGLIPTIN PHOSPHATE TAB 50MG,402497,CDM,637,RC,,,outpatient,,,51.55,33.51,,34.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.8,48.97,
NF-LUNESTA TAB 2MG,402498,CDM,637,RC,,,outpatient,,,56.45,36.69,,37.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.11,53.63,
NF-Eliquis Oral Tablet 5MG,402500,CDM,637,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-ATROPINE SULFATE 1% OPHTHALMIC SOLUTI,402501,CDM,637,RC,,,outpatient,,,4.63,3.01,,3.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.94,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.24,4.4,
EPINEPHRINE DRIP KIT: 1 MG/250 ML (ER),402502,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
LEVONORGESTREL (MIRENA) 52MG Intrauterin,402504,CDM,250,RC,,,outpatient,,,1930,1254.5,,1293.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,540.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,516.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,540.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1408.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1737,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,537.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1544,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1447.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,545.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,516.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,540.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1833.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,526.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1640.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1158,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,540.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1158,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,526.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,516.66,1833.5,
NF-PRESERVISION AREDS 2 ORAL LIQ CAP,402505,CDM,637,RC,,,outpatient,,,0.7,0.46,,0.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.19,0.67,
NF-Cardizem Oral Tablet 30MG,402506,CDM,637,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-Duoderm CGF,402507,CDM,637,RC,,,outpatient,,,84,54.6,,56.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,67.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.49,79.8,
NF-Flecainide Acetate Tablet 100MG,402508,CDM,637,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
NF-LUNESTA ORAL TABLET 1MG,402509,CDM,637,RC,,,outpatient,,,25.57,16.62,,17.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.85,24.29,
NF-Alphagan P Opthamalic Solution  0.1%,402511,CDM,637,RC,,,outpatient,,,105,68.25,,70.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,94.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,78.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.11,99.75,
NF-Azopt Ophth Suspension 1%,402512,CDM,637,RC,,,outpatient,,,102,66.3,,68.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,91.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,81.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.31,96.9,
NF-Eliquis Oral Tablet 5MG,402513,CDM,637,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-Pilocarpine Ophth Solution 4%,402514,CDM,637,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
NF-FENOFIBRATE AVPAK ORAL TABLET 160MG,402515,CDM,637,RC,,,outpatient,,,15.39,10,,10.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.31,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.12,14.62,
NF-ZETIA TAB 10MG,402516,CDM,637,RC,,,outpatient,,,41.4,26.91,,27.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.08,39.33,
NF-MEDROXYPROGESTERONE ACETATE TAB 10MG,402517,CDM,637,RC,,,outpatient,,,5.96,3.87,,3.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.77,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.6,5.66,
NF-MEDROXYPROGESTERONE ACETATE TAB 10MG,402518,CDM,637,RC,,,outpatient,,,1.78,1.16,,1.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.48,1.69,
Iopamidol 61% (ISOVUE-300) Inj (RAD),402520,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-Methotrexate Oral Tablet 2.5MG,402523,CDM,637,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
NF-Lumigan Ophth Solution 0.01%,402525,CDM,637,RC,,,outpatient,,,258,167.7,,172.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,72.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,188.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,232.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,71.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,206.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,193.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,72.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,69.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,245.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,70.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,219.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,154.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,154.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,69.07,245.1,
NF-Pilocarpine Ophth Solution 4%,402526,CDM,637,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
IRBESARTAN (AVAPRO) TABLETS: 150 MG,402527,CDM,250,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-TAMOXIFEN CITRATE TAB 20MG,402528,CDM,637,RC,,,outpatient,,,4.19,2.72,,2.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.35,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.17,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.12,3.98,
NF-PILOCARPINE HCL OPHTH SOLUTION 4%,402529,CDM,637,RC,,,outpatient,,,20.32,13.21,,13.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.29,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.44,19.3,
NF-Eliquis Oral Tablet 2.5MG,402530,CDM,637,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
"NF-NIFEdipine Tablet, Extended-Release 3",402531,CDM,637,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-Flecainide Acetate Tablet 100MG,402532,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-Eliquis Oral Tablet 5MG,402533,CDM,637,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-QUETIAPINE FUMARATE AVPAK TABLET 50MG,402534,CDM,637,RC,,,outpatient,,,18.57,12.07,,12.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.71,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.97,17.64,
NF-SENEXON-S ORAL TABLET 50MG-8.6MG,402535,CDM,637,RC,,,outpatient,,,0.1,0.07,,0.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.09,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.03,0.1,
NF-Pulmicort Inhalant Suspension 0.25MG/,402540,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
NF-ACTOS ORAL TABLET 30MG,402541,CDM,637,RC,,,outpatient,,,32.82,21.33,,21.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.62,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.79,31.18,
NF-FENOFIBRIC ACID CAP DR 135MG,402542,CDM,637,RC,,,outpatient,,,17.84,11.6,,11.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.27,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.78,16.95,
NF-VESICARE ORAL TABLET 5MG,402543,CDM,637,RC,,,outpatient,,,19.48,12.66,,13.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.53,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.58,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.21,18.51,
NF-DICLOFENAC SODIUM CRM 1%,402544,CDM,637,RC,,,outpatient,,,42.9,27.89,,28.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.61,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.48,40.76,
NF-PRADAXA CAP 150MG,402545,CDM,637,RC,,,outpatient,,,24.03,15.62,,16.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.02,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.43,22.83,
NF-SANTYL OINT 250U/1GM,402551,CDM,637,RC,,,outpatient,,,7.07,4.6,,4.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.66,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.89,6.72,
NF-VIMPAT ORAL TABLET 200MG,402552,CDM,637,RC,,,outpatient,,,51.34,33.37,,34.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.51,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.64,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.74,48.77,
NF-FYCOMPA ORAL TABLET 4MG,402553,CDM,637,RC,,,outpatient,,,107.64,69.97,,72.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,96.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,86.11,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,80.73,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,91.49,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,64.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.82,102.26,
NF-NAMZARIC CAP ER 28MG-10MG,402555,CDM,637,RC,,,outpatient,,,50.7,32.96,,33.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.57,48.17,
NF-Theophylline Oral 24Hour Tablet ER 40,402556,CDM,637,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-THEOPHYLLINE 24 HR CAP ER 400MG,402557,CDM,637,RC,,,outpatient,,,18.49,12.02,,12.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.79,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.72,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.95,17.57,
"NF-SIMETHICONE CAPSULE, LIQUID FILLED 12",402560,CDM,637,RC,,,outpatient,,,0.44,0.29,,0.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.35,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.12,0.42,
NF-NITROFURANTOIN MACROCRYSTA CAPSULE 10,402561,CDM,637,RC,,,outpatient,,,12.91,8.39,,8.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.33,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.46,12.26,
NF-CELECOXIB CAP 200MG,402562,CDM,637,RC,,,outpatient,,,17.05,11.08,,11.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.79,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.49,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.56,16.2,
NF-RESTASIS MULTIDOSE OPHTH EMUL 0.05%,402563,CDM,637,RC,,,outpatient,,,279.32,181.56,,187.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,78.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,251.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,77.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,223.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,209.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,78.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,74.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,265.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,76.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,237.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,167.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.77,265.35,
Magnesium Sulf 5 gm/10 ml inj vial,402564,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
NF-Breo Ellipta Inh Pwd 100MCG/1Actuatio,402565,CDM,637,RC,,,outpatient,,,16,10.4,,10.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.28,15.2,
NF-Xarelto Oral Tablet 10MG,402567,CDM,637,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
NF-XARELTO ORAL TABLET 15MG,402570,CDM,637,RC,,,outpatient,,,50.29,32.69,,33.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.23,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.46,47.78,
NF-LAMOTRIGINE ORAL TABLET 25MG,402573,CDM,637,RC,,,outpatient,,,14.92,9.7,,10,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.43,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.19,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.99,14.17,
NF-LAMOTRIGINE ORAL TABLET 25MG,402574,CDM,637,RC,,,outpatient,,,12.45,8.09,,8.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.34,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.33,11.83,
NF-Eliquis Oral Tablet 5MG,402576,CDM,637,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-Pradaxa Oral Capsule 150MG,402577,CDM,637,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
NF-Dorzolamide HCl-Timolol Ophth Soln,402578,CDM,637,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
NF-TRIAMCINOLONE ACETONIDE MM PASTE 0.1%,402579,CDM,637,RC,,,outpatient,,,48.35,31.43,,32.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.26,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.94,45.93,
NF-Eliquis Oral Tablet 5MG,402580,CDM,637,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-ELIQUIS TAB 2.5MG,402581,CDM,637,RC,,,outpatient,,,25.14,16.34,,16.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.11,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.86,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.73,23.88,
NF-lamoTRIgine Oral Tablet 25MG,402582,CDM,637,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
NF-lamoTRIgine Oral Tablet 25MG,402583,CDM,637,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
NF-FLECAINIDE ACETATE AVPAK TAB 50MG,402586,CDM,637,RC,,,outpatient,,,12.16,7.9,,8.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.73,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.26,11.55,
tbo-Filgrastim (Granix) 480 mcg/ml Inj,402587,CDM,636,RC,,,both,,,508,330.2,,340.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,142.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,142.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,254,50,,,percent of total billed charges,50% of billed charges for High Cost Drugs,457.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,141.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,406.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,381,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,143.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,135.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,142.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,482.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,138.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,431.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,304.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,304.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,135.99,482.6,
NF-LATUDA ORAL TABLET 40MG,402588,CDM,637,RC,,,outpatient,,,146.81,95.43,,98.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,41.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,132.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,117.45,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,110.11,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,139.47,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,40.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,124.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,88.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.3,139.47,
NF-ELIQUIS TAB 2.5MG,402589,CDM,637,RC,,,outpatient,,,25.14,16.34,,16.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.11,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.86,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.73,23.88,
NF-Durezol Ophthalmic Emulsion 0.05%,402590,CDM,637,RC,,,outpatient,,,124,80.6,,83.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,34.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,111.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,34.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,99.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,35.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,33.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,105.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,74.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.19,117.8,
NF-Doxepin HCl Oral Capsule 50MG,402591,CDM,637,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-Bromsite Ophthalmic Solution 0.075%,402592,CDM,637,RC,,,outpatient,,,194,126.1,,129.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,54.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,174.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,155.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,145.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,54.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,51.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,184.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,52.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,164.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.93,184.3,
NF-Letairis Oral Tablet 5MG,402593,CDM,637,RC,,,outpatient,,,1110,721.5,,743.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,297.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,810.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,999,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,309.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,888,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,832.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,313.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,297.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1054.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,303.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,943.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,666,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,310.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,666,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,303.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,297.15,1054.5,
NF-TRADJENTA ORAL TABLET 5MG,402594,CDM,637,RC,,,outpatient,,,49.38,32.1,,33.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.04,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.91,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.22,46.91,
NF-MELATONIN ORAL TABLET 5MG,402595,CDM,637,RC,,,outpatient,,,0.35,0.23,,0.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.26,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.09,0.33,
NF-CYPROHEPTADINE HCL ORAL TABLET 4MG,402596,CDM,259,RC,,,outpatient,,,4.82,3.13,,3.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.62,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.29,4.58,
NF-ENTRESTO ORAL TABLET 97MG-103MG,402597,CDM,259,RC,,,outpatient,,,27.8,18.07,,18.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.02,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.44,26.41,
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG,402598,CDM,259,RC,,,outpatient,,,115.48,75.06,,77.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,32.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,103.93,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,92.38,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,86.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,98.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,69.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.91,109.71,
NF-ENVARSUS XR TAB ER 1MG,402600,CDM,259,RC,,,outpatient,,,18.21,11.84,,12.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.57,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.87,17.3,
NF-CELLCEPT CAP 250MG,402601,CDM,259,RC,,,outpatient,,,32.39,21.05,,21.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.77,
NF-MEXILETINE HCL CAP 150MG,402602,CDM,259,RC,,,outpatient,,,2.71,1.76,,1.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.73,2.57,
NF-OXYCODONE/ACETAMINOPHEN TAB 10MG-325M,402603,CDM,259,RC,,,outpatient,,,10.65,6.92,,7.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.85,10.12,
NF-POTASSIUM CHLORIDE ORAL TAB ER 10MEQ,402604,CDM,259,RC,,,outpatient,,,1.91,1.24,,1.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.53,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.81,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.51,1.81,
NF-TRELEGY ELLIPTA INH PWD,402605,CDM,259,RC,,,outpatient,,,31.8,20.67,,21.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.51,30.21,
NF-VIMPAT ORAL TABLET 50MG,402606,CDM,259,RC,,,outpatient,,,34.1,22.17,,22.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.13,32.4,
NF-Nadolol Tablet 40MG,402607,CDM,259,RC,,,outpatient,,,11,7.15,,7.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.94,10.45,
NF-Xifaxan Oral Tablet 550MG,402608,CDM,259,RC,,,outpatient,,,131,85.15,,87.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,98.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.07,124.45,
NF-hydroCHLOROthiazide Oral Tablet 12.5M,402609,CDM,259,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
NF-TIMOLOL MALEATE OPHTH GFS 0.5%,402610,CDM,259,RC,,,outpatient,,,130.36,84.73,,87.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104.29,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.77,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.9,123.84,
NF-AMANTADINE HCL ORAL TABLET 100MG,402611,CDM,259,RC,,,outpatient,,,6.85,4.45,,4.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.83,6.51,
NF-ACETAZOLAMIDE CAP ER 500MG,402616,CDM,259,RC,,,outpatient,,,12.88,8.37,,8.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.45,12.24,
NF-Eliquis Oral Tablet 5MG,402617,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Xarelto Oral Tablet 15MG,402618,CDM,259,RC,,,outpatient,,,53,34.45,,35.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.19,50.35,
NF-XARELTO ORAL TABLET 15MG,402619,CDM,259,RC,,,outpatient,,,53.76,34.94,,36.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.01,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.32,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.39,51.07,
NF-Latuda Oral Tablet 20MG,402620,CDM,259,RC,,,outpatient,,,146,94.9,,97.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,131.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,116.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,109.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,124.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.08,138.7,
NF-Robaxin-750 Oral Tablet 750MG,402621,CDM,259,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
NF-Latuda Oral Tablet 120MG,402622,CDM,259,RC,,,outpatient,,,219,142.35,,146.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,61.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,159.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,197.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,60.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,175.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,164.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,61.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,58.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,208.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,59.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,186.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.63,208.05,
NF-LaMICtal Oral Tablet 100MG,402623,CDM,259,RC,,,outpatient,,,19,12.35,,12.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.09,18.05,
NF-Latuda Oral Tablet 40MG,402624,CDM,259,RC,,,outpatient,,,146,94.9,,97.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,131.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,116.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,109.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,124.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.08,138.7,
NF-busPIRone Oral Tablet 30MG,402625,CDM,259,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
NF-LAMOTRIGINE ORAL TABLET 100MG,402626,CDM,259,RC,,,outpatient,,,15.43,10.03,,10.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.89,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.13,14.66,
NF-LAMOTRIGINE ORAL TABLET 100MG,402627,CDM,259,RC,,,outpatient,,,31.63,20.56,,21.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.47,30.05,
NF-BUSPIRONE HCL ORAL TABLET 30MG,402628,CDM,259,RC,,,outpatient,,,10.9,7.09,,7.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.36,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.27,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.92,10.36,
NF-Zonisamide Oral Capsule 50MG,402629,CDM,259,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-ZONISAMIDE CAP 100MG,402630,CDM,259,RC,,,outpatient,,,6.58,4.28,,4.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.76,6.25,
NF-ZONISAMIDE CAP 100MG,402631,CDM,259,RC,,,outpatient,,,6.58,4.28,,4.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.76,6.25,
NF-Theophylline Oral 24Hour Tablet ER 40,402633,CDM,259,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Amantadine HCl Oral Capsule 100MG,402634,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Amantadine HCL Oral Capsule 100MG,402635,CDM,259,RC,,,outpatient,,,5,3.25,,3.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,4.75,
NF-rOPINIRole Hydrochloride Oral Tablet,402636,CDM,259,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-Trintellix Oral Tablet 10MG,402638,CDM,259,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
NF-Amantadine HCL Oral Capsule 100MG,402640,CDM,259,RC,,,outpatient,,,5,3.25,,3.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,4.75,
NF-Requip Tablet 5MG,402641,CDM,259,RC,,,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.35,19,
NF-Eliquis Oral Tablet 5MG,402642,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Xarelto Oral Tablet 15MG,402645,CDM,259,RC,,,outpatient,,,53,34.45,,35.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.19,50.35,
NF-Entresto Oral Tablet 49MG-51MG,402646,CDM,259,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
NF-Fenofibrate Oral Tablet 145MG,402648,CDM,259,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
NF-Amantadine HCL Oral Capsule 100MG,402649,CDM,259,RC,,,outpatient,,,5,3.25,,3.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,4.75,
NF-Requip Tablet 5MG,402650,CDM,259,RC,,,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.35,19,
NF-Ipratropium Bromide Inh Soln 0.02%,402651,CDM,259,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
NF-Flecainide Acetate Oral Tablet 100MG,402652,CDM,259,RC,,,outpatient,,,14,9.1,,9.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.75,13.3,
NF-Lumigan Ophth Solution 0.01%,402655,CDM,259,RC,,,outpatient,,,283,183.95,,189.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,254.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,226.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,212.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.76,268.85,
NF-Adempas Oral Tablet 2.5MG,402659,CDM,259,RC,,,outpatient,,,390,253.5,,261.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,284.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,351,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,108.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,312,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,292.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,110.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,104.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,370.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,106.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,331.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,234,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.4,370.5,
NF-Letairis Oral Tablet 5MG,402660,CDM,259,RC,,,outpatient,,,1164,756.6,,779.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,325.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,311.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,325.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,849.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1047.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,324.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,931.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,873,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,329.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,311.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,325.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1105.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,317.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,989.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,698.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,698.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,317.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,311.6,1105.8,
NF-Eliquis Oral Tablet 5MG,402664,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Voltaren Gel Topical 1%,402665,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Eliquis Oral Tablet 5MG,402666,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Flecainide Acetate Tablet 100MG,402667,CDM,259,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-Venlafaxine HCl Oral Tablet 100MG,402668,CDM,259,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-METFORMIN ER ORAL TAB ER 500MG,402669,CDM,259,RC,,,outpatient,,,2.13,1.38,,1.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.57,2.02,
NF-DONEPEZIL HCL ORAL TABLET 10MG,402670,CDM,259,RC,,,outpatient,,,23.31,15.15,,15.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.65,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.24,22.14,
NF-Eliquis Oral Tablet 5MG,402671,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Eliquis Oral Tablet 5MG,402672,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Anoro Ellipta Inhalation Powder,402673,CDM,259,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-VESIcare Oral Tablet 5MG,402674,CDM,259,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-Jentadueto Oral Tablet 2.5MG-500MG,402675,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-VESIcare Oral Tablet 10MG,402676,CDM,259,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-Eliquis Oral Tablet 5MG,402677,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Eliquis Oral Tablet 5MG,402678,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Dorzolamide HCl-Timolol 22.3MG-6.8MG/,402679,CDM,259,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
NF-Eliquis Oral Tablet 5MG,402682,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Tacrolimus Oral Capsule 1MG,402684,CDM,259,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
NF-Linzess Oral Capsule 145MCG,402685,CDM,259,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
NF-Prazosin HCl Capsule 1MG,402686,CDM,259,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
NF-Zetia Tablet 10MG,402687,CDM,259,RC,,,outpatient,,,40,26,,26.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,38,
NF-Indapamide Oral Tablet 1.25MG,402691,CDM,259,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Eliquis Oral Tablet 5MG,402692,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Eliquis Oral Tablet 5MG,402693,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Eliquis Oral Tablet 5MG,402697,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Midodrine HCl Oral Tablet 10MG,402699,CDM,259,RC,,,outpatient,,,14,9.1,,9.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.75,13.3,
NF-Midodrine HCl Oral Tablet 10MG,402700,CDM,259,RC,,,outpatient,,,14,9.1,,9.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.75,13.3,
NF-Casodex Tablet 50MG,402701,CDM,259,RC,,,outpatient,,,69,44.85,,46.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,62.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,55.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.47,65.55,
NF-Eliquis Oral Tablet 2.5MG,402702,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Memantine HCl Oral Capsule ER 28MG,402703,CDM,259,RC,,,outpatient,,,45,29.25,,30.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,40.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.05,42.75,
NF-Timolol Maleate Ophth Solution 0.5%,402704,CDM,259,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
NF-Eliquis Oral Tablet 5MG,402705,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Casodex Oral Tablet 50mg,402706,CDM,259,RC,,,outpatient,,,361,234.65,,241.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,101.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,101.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,263.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,324.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,100.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,288.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,270.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,102.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,96.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,101.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,98.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,306.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,98.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,96.64,342.95,
NF-Dorzolamide HCl-Timolol 22.3MG-6.8MG/,402707,CDM,259,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
NF-Dorzolamide HCl-Timolol 22.3MG-6.8MG/,402708,CDM,259,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
NF-Pristiq Extended-Release Tablet 50MG,402709,CDM,259,RC,,,outpatient,,,48,31.2,,32.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.85,45.6,
NF-TEGretol Oral Suspension 100MG/5ML,402713,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-METOPROLOL SUCCINATE CAP ER 25MG,402714,CDM,259,RC,,,outpatient,,,5.22,3.39,,3.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.92,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.4,4.96,
NF-METOPROLOL SUCCINATE ER TAB ER 25MG,402715,CDM,259,RC,,,outpatient,,,3.16,2.05,,2.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.53,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,3,
NF-Lidoderm Patch 5%,402716,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Lotemax Ophth Suspension 0.5%,402720,CDM,259,RC,,,outpatient,,,171,111.15,,114.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,153.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,47.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,136.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,128.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,48.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,162.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,145.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,102.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.78,162.45,
NF-Desvenlafaxine Oral Tab ER 25MG,402721,CDM,259,RC,,,outpatient,,,34,22.1,,22.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,32.3,
NF-Desvenlafaxine Oral Tab ER 100MG,402722,CDM,259,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
NF-Eliquis Oral Tablet 2.5MG,402723,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Nadolol Tablet 40MG,402724,CDM,259,RC,,,outpatient,,,11,7.15,,7.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.94,10.45,
NF-Xifaxan Oral Tablet 550MG,402725,CDM,259,RC,,,outpatient,,,142,92.3,,95.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,127.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,113.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,106.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,120.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.01,134.9,
NF-Eliquis Oral Tablet 5MG,402726,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Symbicort Inh Aer Liq 160MCG-4.5MCG,402729,CDM,259,RC,,,outpatient,,,115,74.75,,77.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,32.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,103.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,86.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,97.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.79,109.25,
NF-Ketorolac Tromethamine Ophth Soln 0.5,402730,CDM,259,RC,,,outpatient,,,64,41.6,,42.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.13,60.8,
NF-Januvia Oral Tablet 100MG,402731,CDM,259,RC,,,outpatient,,,54,35.1,,36.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,51.3,
NF-Xarelto Oral Tablet 20MG,402732,CDM,259,RC,,,outpatient,,,53,34.45,,35.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.19,50.35,
NF-Farxiga Oral Tablet 5MG,402733,CDM,259,RC,,,outpatient,,,37,24.05,,24.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.9,35.15,
NF-Xarelto Oral Tablet 20MG,402734,CDM,259,RC,,,outpatient,,,53,34.45,,35.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.19,50.35,
NF-Cyproheptadine HCl Oral Tablet 4MG,402735,CDM,259,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
NF-Anoro Ellipta Inhalation Powder,402736,CDM,259,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-Eliquis Oral Tablet 5MG,402737,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Propafenone HCl Tablet 150MG,402738,CDM,259,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Eliquis Oral Tablet 2.5MG,402739,CDM,259,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-Eliquis Oral Tablet 5MG,402740,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Eliquis Oral Tablet 2.5MG,402742,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Propafenone HCl Oral Tablet 150MG,402743,CDM,259,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Entresto Oral Tablet 97MG-103MG,402744,CDM,259,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
NF-Flecainide Acetate Tablet 100MG,402745,CDM,259,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-Lumigan Ophth Solution 0.01%,402746,CDM,259,RC,,,outpatient,,,283,183.95,,189.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,254.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,226.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,212.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.76,268.85,
RABIES IMMUNE GLOB 300UNITS/ML INJ: 5 ML,402749,CDM,250,RC,,,outpatient,,,924,600.6,,619.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,247.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,674.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,831.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,257.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,739.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,693,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,261.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,247.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,877.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,252.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,785.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,554.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,554.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,247.35,877.8,
RABIES IMMUNE GLOB 300UNITS/ML INJ: 1 ML,402750,CDM,250,RC,,,outpatient,,,924,600.6,,619.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,247.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,674.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,831.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,257.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,739.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,693,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,261.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,247.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,877.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,252.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,785.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,554.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,554.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,247.35,877.8,
NF-Xifaxan Oral Tablet 550MG,402752,CDM,259,RC,,,outpatient,,,142,92.3,,95.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,127.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,113.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,106.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,120.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.01,134.9,
NF-Nadolol         Tab  20MG,402753,CDM,259,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-VESIcare Oral Tablet 5MG,402755,CDM,259,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-Pioglitazone HCl Oral Tablet 30MG,402756,CDM,259,RC,,,outpatient,,,32,20.8,,21.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.57,30.4,
NF-Fenofibric Acid Oral Cap DR 135MG,402757,CDM,259,RC,,,outpatient,,,16,10.4,,10.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.28,15.2,
NF-Jardiance Oral Tablet 10MG,402759,CDM,259,RC,,,outpatient,,,59,38.35,,39.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,53.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.79,56.05,
NF-Eliquis Oral Tablet 5MG,402760,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
Cefepime 2gm Injection *NF*,402762,CDM,250,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
NF-Eliquis Oral Tablet 5MG,402766,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Vimpat Oral Tablet 50MG,402769,CDM,259,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
NF-Anoro Ellipta Inhalation Powder,402771,CDM,259,RC,,,outpatient,,,24,15.6,,16.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.42,22.8,
NF-NIFEdipine ER Tablet 60MG,402772,CDM,259,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-Evista Oral Tablet 60MG,402773,CDM,259,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
NF-diazePAM Rectal Delivery System Kit,402778,CDM,259,RC,,,outpatient,,,1092,709.8,,731.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,305.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,292.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,305.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,797.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,982.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,304.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,873.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,819,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,308.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,292.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,305.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1037.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,298.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,928.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,655.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,305.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,655.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,298.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,292.33,1037.4,
NF-lamoTRIgine Oral Tablet 200MG,402779,CDM,259,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
NF-Xifaxan Oral Tablet 550MG,402780,CDM,259,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
TIOTROPIUM (SPIRIVA RESPIMAT):2.5MCG/ACT,402781,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
Levonorgestrel 1.5 mg Tablet (MY WAY),402782,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
NF-Inderal LA Oral Capsule ER 160MG,402785,CDM,259,RC,,,outpatient,,,259,168.35,,173.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,72.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,189.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,233.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,72.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,207.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,194.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,73.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,69.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,246.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,70.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,220.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,69.33,246.05,
NF-METHOCARBAMOL  TAB  750MG,402786,CDM,259,RC,,,outpatient,,,0.81,0.53,,0.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.73,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.65,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.22,0.77,
NF-ABILIFY ORAL TABLET 10MG,402787,CDM,259,RC,,,outpatient,,,43.57,28.32,,29.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.39,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.66,41.39,
NF-CALCIPOTRIENE CRM 0.005%,402788,CDM,259,RC,,,outpatient,,,14.59,9.48,,9.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.67,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.94,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.91,13.86,
NF-Pramipexole Dihydrochloride Tab 1MG,402789,CDM,259,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-Pradaxa Oral Capsule 150MG,402790,CDM,259,RC,,,outpatient,,,24,15.6,,16.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.42,22.8,
NF-Welchol Oral Tablet 625MG,402791,CDM,259,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Folic Acid Oral Tablet 1MG,402792,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
LAMOTRIGINE (LAMICTAL) TABS: 25 MG,402793,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MEROPENEM (MERREM) 1GM/100ML INFUSION,402795,CDM,250,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
NF-Eliquis Oral Tablet 5MG,402796,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Tamoxifen Citrate Oral Tablet 20MG,402797,CDM,259,RC,,,outpatient,,,11,7.15,,7.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.94,10.45,
NF-Budesonide Delayed Release Capsule 3M,402798,CDM,259,RC,,,outpatient,,,56,36.4,,37.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.99,53.2,
NF-TRILEPTAL ORAL TABLET 150MG,402799,CDM,259,RC,,,outpatient,,,17.2,11.18,,11.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.6,16.34,
NF-NIFEdipine Extended-Release Tablet 60,402800,CDM,259,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-NIFEdipine Tablet ER 60MG,402802,CDM,259,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-Minoxidil Tablet 2.5MG,402805,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-NIFEdipine Oral Tab ER 90MG,402806,CDM,259,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
NF-Methocarbamol Tablet 500MG,402807,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
CALCIUM CHLORID 10% INJ VIAL: 1 GM/10 ML,402808,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-Lumigan Ophth Solution 0.01%,402810,CDM,259,RC,,,outpatient,,,283,183.95,,189.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,254.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,226.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,212.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.76,268.85,
NF-busPIRone HCl Oral Tablet 7.5MG,402811,CDM,259,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Xarelto Oral Tablet 15MG,402812,CDM,259,RC,,,outpatient,,,53,34.45,,35.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.19,50.35,
NF-Refresh Optive Advanced Ophth Soln,402814,CDM,259,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-Restasis Multidose Ophth Emulsion 0.0,402815,CDM,259,RC,,,outpatient,,,279,181.35,,186.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,251.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,77.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,223.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,209.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,78.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,74.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,265.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,76.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,237.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,167.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.69,265.05,
NF-Brimonidine Tartrate Ophth Soln 0.15%,402816,CDM,259,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-BETIMOL OPHTH SOLN 0.5%,402818,CDM,259,RC,,,outpatient,,,46.62,30.3,,31.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,37.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.97,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.48,44.29,
NF-Namzaric Oral Cap ER 28MG-10MG,402819,CDM,259,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
NF-Restasis Ophthalmic Emulsion 0.05%,402821,CDM,259,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
NF-Betimol Ophth Solution 0.5%,402822,CDM,259,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
NF-Eliquis Oral Tablet 5MG,402823,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Ezetimibe Oral Tablet 10MG,402824,CDM,259,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
NF-Eliquis Oral Tablet 2.5MG,402825,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Methylphenidate Oral Tab ER 10MG,402826,CDM,259,RC,,,outpatient,,,9,5.85,,6.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.41,8.55,
NF-Methocarbamol Tablet 500MG,402827,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Brimonidine Tartrate Ophth Soln 0.15%,402829,CDM,259,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-Refresh Optive Advanced Ophth Soln,402830,CDM,259,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-Restasis Ophthalmic Emulsion 0.05%,402831,CDM,259,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
NF-Eliquis Oral Tablet 5MG,402832,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-SENNA PLUS ORAL TABLET 50MG-8.6MG,402839,CDM,259,RC,,,outpatient,,,0.07,0.05,,0.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.07,
NF-GLUCOSAMINE CHONDROITIN 1500 COM CAPS,402840,CDM,259,RC,,,outpatient,,,0.86,0.56,,0.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.69,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.23,0.82,
NF-BUMETANIDE ORAL TABLET 1MG,402841,CDM,259,RC,,,outpatient,,,3.27,2.13,,2.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.88,3.11,
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,402842,CDM,259,RC,,,outpatient,,,3.31,2.15,,2.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.65,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.89,3.14,
NF-BETADINE SWAB 10%,402843,CDM,259,RC,,,outpatient,,,0.89,0.58,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.71,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.76,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.85,
NF-KLOR-CON 10 ORAL TAB ER 10MEQ,402844,CDM,259,RC,,,outpatient,,,1.95,1.27,,1.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.46,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.52,1.85,
NF-BENZONATATE CAPSULE LIQUID FILLED 200,402845,CDM,259,RC,,,outpatient,,,4.73,3.07,,3.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.27,4.49,
NF-Mesalamine Oral Tablet DR 1.2GM,402847,CDM,259,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
NF-Eliquis Oral Tablet 5MG,402848,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Torsemide Oral Tablet 20MG,402849,CDM,259,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-Eliquis Oral Tablet 5MG,402850,CDM,259,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-Eliquis Oral Tablet 2.5MG,402851,CDM,259,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-ELIQUIS ORAL TABLET 5MG,402852,CDM,259,RC,,,outpatient,,,26.65,17.32,,17.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.99,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.32,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.13,25.32,
NF-Eliquis Oral Tablet 5MG,402853,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Bumetanide Oral Tablet 1MG,402854,CDM,259,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-Eliquis Oral Tablet 5MG,402855,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Tamoxifen Citrate Oral Tablet 20MG,402856,CDM,259,RC,,,outpatient,,,11,7.15,,7.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.94,10.45,
NF-NIFEdipine Extended-Release Tablet 90,402858,CDM,259,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
OLANZEPINE (ZYPREXA) INJECTION: 10 MG,402860,CDM,250,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
NF-Lidocaine Topical Extended Release Pa,402862,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Patanol Ophth Solution 0.1%,402863,CDM,259,RC,,,outpatient,,,209,135.85,,140.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,58.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,188.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,58.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,167.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,156.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,59.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,55.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,198.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,57.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,177.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.95,198.55,
NF-Methotrexate Oral Tablet 2.5MG,402865,CDM,259,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
NF-Astelin Ready-Spray Nasal,402866,CDM,259,RC,,,outpatient,,,14,9.1,,9.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.75,13.3,
NF-Xarelto Oral Tablet 20MG,402867,CDM,259,RC,,,outpatient,,,53,34.45,,35.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.19,50.35,
NF-LORazepam Intensol Concentrate 2MG/ML,402868,CDM,259,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Eliquis Oral Tablet 5MG,402870,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-tetrabenazine Oral Tablet 25MG,402871,CDM,259,RC,,,outpatient,,,472,306.8,,316.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,132.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,132.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,344.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,424.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,131.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,377.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,354,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,133.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,126.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,132.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,448.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,128.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,401.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,283.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,283.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,126.35,448.4,
NF-Amantadine HCl Oral Capsule 100MG,402872,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Eliquis Oral Tablet 5MG,402874,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Flecainide Oral Tablet 150MG,402875,CDM,259,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
NF-Flecainide Acetate AvPak Tablet 150MG,402876,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Travoprost Ophthalmic Solution 0.004%,402878,CDM,259,RC,,,outpatient,,,238,154.7,,159.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,66.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,214.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,66.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,190.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,178.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,67.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,63.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,226.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,202.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.71,226.1,
NF-Eliquis Oral Tablet 5MG,402880,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-Captopril Tablet 12.5MG,402881,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Eliquis Oral Tablet 5MG,402882,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Acular Ophthalmic Solution 0.5%,402884,CDM,259,RC,,,outpatient,,,188,122.2,,125.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,52.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,137.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,169.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,52.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,150.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,141,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,53.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,50.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,51.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,159.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.33,178.6,
NF-POTASSIUM CHELATED TABLET 99MG,402887,CDM,259,RC,,,outpatient,,,0.12,0.08,,0.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.09,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.03,0.11,
NF-CLARITHROMYCIN ORAL TABLET 500MG,402888,CDM,259,RC,,,outpatient,,,14.24,9.26,,9.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.39,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.81,13.53,
NF-TERAZOSIN HCL CAP 10MG,402889,CDM,259,RC,,,outpatient,,,4.81,3.13,,3.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.33,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.85,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.61,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.09,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.29,4.57,
NF-SPIRIVA INH/NEB CAP 18MCG,402890,CDM,259,RC,,,outpatient,,,26.76,17.39,,17.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.16,25.42,
NF-MUCUS RELIEF DM COUGH TABLET 20MG-400,402891,CDM,259,RC,,,outpatient,,,0.22,0.14,,0.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.17,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.06,0.21,
NF-Ketotifen Fumarate Ophth Solution 0.0,402893,CDM,259,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
Propofol (Diprivan)  500mg/50ml INJ,402894,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-NIFEdipine Tablet Extended-Release 90,402895,CDM,259,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
NF-Alphagan P Ophth Solution 0.15%,402896,CDM,259,RC,,,outpatient,,,128,83.2,,85.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,115.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,35.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,102.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,96,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,34.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,108.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,76.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.27,121.6,
NF-Eliquis Oral Tablet 5MG,402897,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Eliquis Oral Tablet 5MG,402898,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Eliquis Oral Tablet 2.5MG,402899,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Pramipexole Dihydrochloride Oral Tabl,402900,CDM,259,RC,,,outpatient,,,48,31.2,,32.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.85,45.6,
NF-Eliquis Oral Tablet 5MG,402903,CDM,259,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
NF-SPIRONOLACTONE ORAL TAB 50MG,402904,CDM,259,RC,,,outpatient,,,2.45,1.59,,1.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.66,2.33,
NF-HYDROXYZINE PAMOATE CAP 50MG,402906,CDM,259,RC,,,outpatient,,,1.8,1.17,,1.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.48,1.71,
NF-Eliquis Oral Tablet 2.5MG,402908,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Eliquis Oral Tablet 2.5MG,402910,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Timolol Maleate Ophth Solution 0.25%,402911,CDM,259,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
NF-Jardiance Oral Tablet 25MG,402912,CDM,259,RC,,,outpatient,,,62,40.3,,41.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.6,58.9,
NF-Creon Oral Cap DR 180000U-36000U-1140,402913,CDM,259,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
NF-Entresto Oral Tablet 97MG-103MG,402914,CDM,259,RC,,,outpatient,,,32,20.8,,21.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.57,30.4,
NF-Duoderm CGF,402915,CDM,259,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
NF-Lumigan Ophth Solution 0.01%,402916,CDM,259,RC,,,outpatient,,,297,193.05,,198.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,216.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,267.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,82.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,222.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,282.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,252.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.51,282.15,
NF-Pilocarpine Ophth Solution 4%,402917,CDM,259,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
NF-Eliquis Oral Tablet 5MG,402918,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Lumigan Ophth Solution 0.01%,402919,CDM,259,RC,,,outpatient,,,297,193.05,,198.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,216.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,267.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,82.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,222.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,282.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,252.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.51,282.15,
NF-Combigan Ophth Soln 0.2%-0.5%,402920,CDM,259,RC,,,outpatient,,,133,86.45,,89.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,119.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.6,126.35,
NF-Duoderm CGF,402921,CDM,259,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
NF-Pramipexole Dihydrochloride Tab 1.5MG,402922,CDM,259,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
NF-Eliquis Oral Tablet 5MG,402923,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Combigan Ophth Soln 0.2%-0.5%,402925,CDM,259,RC,,,outpatient,,,66,42.9,,44.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.67,62.7,
NF-Lumigan Ophth Solution 0.01%,402926,CDM,259,RC,,,outpatient,,,297,193.05,,198.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,216.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,267.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,82.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,222.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,282.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,252.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.51,282.15,
NF-Refresh Optive Mega-3 Ophth Soln,402927,CDM,259,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NF-Fluorometholone Ophth Suspension 0.1%,402928,CDM,259,RC,,,outpatient,,,24,15.6,,16.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.42,22.8,
NF-Oxazepam Capsule 15MG,402930,CDM,259,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-Incruse Ellipta Inh Pwd 62.5MCG/1ACT,402931,CDM,259,RC,,,outpatient,,,37,24.05,,24.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.9,35.15,
NF-Oxazepam Capsule 15MG,402933,CDM,259,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
NF-Eliquis Oral Tablet 2.5MG,402934,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
Propofol (Diprivan) 1000 mg/100 ml premx,402936,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-Xarelto Oral Tablet 15MG,402938,CDM,259,RC,,,outpatient,,,56,36.4,,37.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.99,53.2,
NF-LORazepam Intensol Concentrate 2MG/ML,402939,CDM,259,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Onglyza Oral Tablet 5MG,402940,CDM,259,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
NF-Tecfidera Oral Cap DR 240MG,402941,CDM,259,RC,,,outpatient,,,496,322.4,,332.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,138.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,138.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,362.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,446.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,138.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,396.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,372,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,140.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,132.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,138.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,135.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,421.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,297.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,297.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,132.78,471.2,
NF-Tecfidera Oral Cap DR 240MG,402942,CDM,259,RC,,,outpatient,,,496,322.4,,332.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,138.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,138.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,362.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,446.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,138.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,396.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,372,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,140.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,132.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,138.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,135.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,421.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,297.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,297.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,132.78,471.2,
Sugammadex (Bridion) 200 mg/2 mL Inj,402944,CDM,250,RC,,,outpatient,,,220,143,,147.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,198,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,61.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,176,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,165,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,62.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,209,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,187,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.89,209,
NF-Trulicity SubQ Solution 0.75MG/0.5ML,402945,CDM,259,RC,,,outpatient,,,1435,932.75,,961.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,401.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,384.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,401.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1047.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1291.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,399.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1076.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,405.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,384.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,401.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1363.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,391.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1219.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,861,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,401.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,861,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,391.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,384.15,1363.25,
NF-Eliquis Oral Tablet 5MG,402946,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Valsartan/HCTZ Oral Tablet 80MG-12.5M,402951,CDM,259,RC,,,outpatient,,,11,7.15,,7.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.94,10.45,
NF-Pradaxa Oral Capsule 150MG,402952,CDM,259,RC,,,outpatient,,,24,15.6,,16.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.42,22.8,
Zinc Gluconate 100 mg tablets,402954,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-Mirapex Oral Tablet 1.5MG,402955,CDM,259,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NF-HALOPERIDOL CONCENTRATE 2MG/ML,402956,CDM,259,RC,,,outpatient,,,1.36,0.88,,0.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.02,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.29,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.36,1.29,
NF-Symbicort Inh Aer Liq 160MCG-4.5MCG,402957,CDM,259,RC,,,outpatient,,,128,83.2,,85.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,115.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,35.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,102.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,96,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,34.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,108.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,76.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.27,121.6,
NF-Symbicort Inh Aer Liq 160MCG-4.5MCG,402959,CDM,259,RC,,,outpatient,,,128,83.2,,85.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,115.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,35.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,102.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,96,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,34.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,108.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,76.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.27,121.6,
NF-PERMETHRIN CRM 5%,402960,CDM,259,RC,,,outpatient,,,5.9,3.84,,3.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.31,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.58,5.61,
NF-Trulicity SubQ Solution 0.75MG/0.5ML,402961,CDM,259,RC,,,outpatient,,,1435,932.75,,961.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,401.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,384.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,401.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1047.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1291.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,399.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1076.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,405.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,384.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,401.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1363.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,391.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1219.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,861,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,401.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,861,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,391.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,384.15,1363.25,
NF-Dexamethasone Oral Tablet 2MG,402966,CDM,259,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
NF-Combivent Respimat Inhalation Spray,402968,CDM,259,RC,,,outpatient,,,383,248.95,,256.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,107.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,107.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,279.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,344.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,106.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,306.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,287.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,108.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,102.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,107.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,363.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,104.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,325.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,229.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,229.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102.53,363.85,
NF-Eliquis Oral Tablet 5MG,402970,CDM,259,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
NF-Dexamethasone Oral Tablet 2MG,402971,CDM,259,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NF-Stiolto Respimat Inh 2.5-2.5MCG/1Act,402972,CDM,259,RC,,,outpatient,,,379,246.35,,253.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,106.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,106.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,276.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,341.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,105.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,303.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,284.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,107.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,101.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,106.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,360.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,103.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,322.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,227.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,227.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,101.46,360.05,
NF-Dorzolamide Hydrochloride/Timolol Sol,402975,CDM,259,RC,,,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.35,19,
NF-Travatan Z Ophthalmic Solution 0.004%,402976,CDM,259,RC,,,outpatient,,,279,181.35,,186.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,251.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,77.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,223.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,209.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,78.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,74.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,265.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,76.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,237.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,167.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.69,265.05,
NF-Fenofibrate AvPak Oral Tablet 145MG,402977,CDM,259,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
NF-Dorzolamide HCl-Timolol 22.3MG-6.8MG/,402978,CDM,259,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
NF-Travatan Z Ophthalmic Solution 0.004%,402979,CDM,259,RC,,,outpatient,,,279,181.35,,186.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,251.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,77.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,223.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,209.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,78.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,74.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,265.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,76.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,237.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,167.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.69,265.05,
NF-Fenofibrate AvPak Oral Tablet 145MG,402980,CDM,259,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
NF-Exemestane Oral Tablet 25MG,402981,CDM,259,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NF-Myrbetriq Oral Tablet 50MG,402982,CDM,259,RC,,,outpatient,,,48,31.2,,32.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.85,45.6,
NF-Toviaz Oral Extended Release Tablet 4,402983,CDM,259,RC,,,outpatient,,,41,26.65,,27.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.98,38.95,
NF-Welchol Oral Tablet 625MG,402984,CDM,259,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
NF-Combigan Ophth Soln 0.2%-0.5%,402985,CDM,259,RC,,,outpatient,,,133,86.45,,89.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,119.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.6,126.35,
NF-Lumigan Ophth Solution 0.01%,402986,CDM,259,RC,,,outpatient,,,297,193.05,,198.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,216.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,267.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,82.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,222.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,282.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,252.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.51,282.15,
NF-Xifaxan Oral Tablet 550MG,402988,CDM,259,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
NF-Pradaxa Oral Capsule 150MG,402989,CDM,259,RC,,,outpatient,,,24,15.6,,16.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.42,22.8,
NF-Xarelto Oral Tablet 20MG,402990,CDM,259,RC,,,outpatient,,,56,36.4,,37.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.99,53.2,
NF-Tresiba Subcutaneous Solution 100U/1M,402994,CDM,259,RC,,,outpatient,,,122,79.3,,81.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,34.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,109.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,97.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,91.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,103.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.66,115.9,
WATER FOR INJECTION 2000ml,711807,CDM,258,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
AKWA TEAR 3.5gm OINT,806235,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
LATANOPROST (XALATAN) 0.005% OPTH DROPS,830304,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
PT MUSCLE TESTING MANUAL HAND,1060060,CDM,420,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
PT ROM EXTREMITY/TRUNK,1060077,CDM,420,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
PT ROM EXTREMITY/TRUNK,1060079,CDM,420,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
OT ROM HAND,1070016,CDM,430,RC,,,outpatient,,,18.5,12.03,,12.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.95,17.58,
OT MUSCLE TESTING MANUAL HAND,1070018,CDM,430,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
OT ROM EXT/TRUNK,1070021,CDM,430,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
MM DIAGNOSTIC MAMMO UNILATERAL W/CAD L,1377065,CDM,401,RC,,,outpatient,,,624,405.6,,418.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,174.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,174.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,455.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,561.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,173.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,499.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,468,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,176.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,167.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,174.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,592.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,170.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,530.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,374.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,374.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,167.04,592.8,
MM SCREENING MAMMO 1 BREAST 2 VIEW W/CAD,1377067,CDM,403,RC,,,outpatient,,,424.5,275.93,,284.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,118.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,118.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,309.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,382.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,118.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,339.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,318.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,120.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,113.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,118.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,403.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,115.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,360.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,254.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,254.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.64,403.28,
"IV PUSH, SINGLE DRUG",3000005,CDM,260,RC,,,outpatient,,,248,161.2,,166.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,69.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,69.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,223.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,69.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,198.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,186,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,70.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,66.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,69.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,235.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,148.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,148.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,66.39,235.6,
IV INFUSION THERAPY UP TO 1 HR,3000007,CDM,260,RC,,,outpatient,,,348.5,226.53,,233.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,97.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,97.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,254.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,313.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,97.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,278.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,261.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,98.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,93.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,97.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,331.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,95.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,296.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,209.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,209.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.29,331.08,
IV INFUSION THERAPY @ ADD'L HR UP TO 8,3000008,CDM,260,RC,,,outpatient,,,156,101.4,,104.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,140.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,124.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,117,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,44.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,148.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,132.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.76,148.2,
IVP each sequential new drug,3000009,CDM,260,RC,,,outpatient,,,94.5,61.43,,63.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,75.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,70.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,56.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.3,89.78,
ADMIN INFLUENZA VACCINE,3000010,CDM,771,RC,,,outpatient,,,68.4,44.46,,45.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,41.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.31,64.98,
ADMIN PNEUMOCOCCAL VACCINE,3000011,CDM,771,RC,,,outpatient,,,68.4,44.46,,45.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,41.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.31,64.98,
IV INF HYDRATION @ ADD'L HR UP TO 8 HRS,3000012,CDM,260,RC,,,outpatient,,,92,59.8,,61.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,82.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,73.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,78.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.63,87.4,
IV INFUSION FOR THERAPY UP TO 1hr,3000013,CDM,260,RC,,,outpatient,,,631.5,410.48,,423.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,176.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,461,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,568.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,175.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,505.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,473.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,178.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,169.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,599.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,172.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,536.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,378.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,378.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,172.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,169.05,599.93,
INTRAVENOUS INFUSION; ADD'L SEQ TO 1 HR,3000014,CDM,260,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
IV INFUSION; CONCURRENT INFUSION,3000015,CDM,260,RC,,,outpatient,,,24.5,15.93,,16.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.56,23.28,
IVP EACH sequential same drug,3000016,CDM,260,RC,,,outpatient,,,190,123.5,,127.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,53.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,171,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,52.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,152,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,142.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,53.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,50.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,180.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,51.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,161.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.86,180.5,
INSERT NON TUNNEL CV CATH 5+,3036556,CDM,360,RC,,,outpatient,,,1968.6,1279.59,,1318.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,526.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1437.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1771.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,548.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1574.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1476.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,556.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,526.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1870.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,537.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1673.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1181.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1181.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,537.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,526.99,1870.17,
PERITONEOCENTESIS/ABD PARACENTESIS,3049080,CDM,360,RC,,,outpatient,,,742.2,482.43,,497.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,207.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,198.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,207.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,541.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,667.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,206.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,593.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,556.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,209.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,198.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,207.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,705.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,202.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,630.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,445.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,445.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,198.69,705.09,
I & D EPIDIDYMIS TESTIS SCROTUM,3054700,CDM,360,RC,,,outpatient,,,3115.8,2025.27,,2087.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,834.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2274.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2804.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,867.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2492.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2336.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,881.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,834.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2960.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,850.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2648.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1869.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1869.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,850.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,834.1,2960.01,
COT RENTAL,3100020,CDM,990,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
OBSERVATION HOSPITAL PER HR,3100125,CDM,762,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
RECOVERY (MED-SURG),3100130,CDM,710,RC,,,outpatient,,,36.6,23.79,,24.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.8,34.77,
IM SUB Q INJECTION,3100136,CDM,260,RC,,,outpatient,,,240.5,156.33,,161.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,175.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,216.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,66.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,192.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,180.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,68.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,64.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,228.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,65.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,204.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,144.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.38,228.48,
COLONOSCOPY W/REMOVAL BY SNARE TECHNIQUE,4010031,CDM,750,RC,,,outpatient,,,3015,1959.75,,2020.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,844.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,807.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,844.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2200.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2713.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,839.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2412,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2261.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,852.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,807.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,844.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2864.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,823.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2562.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1809,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,844.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1809,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,823.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,807.12,2864.25,
COLONOSCOPY W OR W/O SPECIMEN WASH/BRUSH,4010032,CDM,750,RC,,,outpatient,,,4227.5,2747.88,,2832.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1183.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1131.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1183.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3086.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3804.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1176.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3382,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3170.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1195.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1131.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1183.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4016.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1154.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3593.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2536.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1183.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2536.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1154.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1131.7,4016.13,
COLONOSCOPY COLORECTAL CA SCREENING,4010033,CDM,360,RC,,,outpatient,,,350,227.5,,234.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,315,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,97.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,280,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,262.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,98.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,93.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,332.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,95.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,297.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.7,332.5,
UPPER GI ENDO DIAG BRUSH / WASH,4010035,CDM,750,RC,,,outpatient,,,1001.5,650.98,,671.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,280.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,280.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,731.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,901.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,278.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,801.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,751.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,283.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,268.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,280.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,951.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,273.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,851.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,600.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,280.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,600.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,273.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,268.1,951.43,
SIGMOIDOSCOPY WITH BIOPSY,4010037,CDM,360,RC,,,outpatient,,,787.8,512.07,,527.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,575.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,709.02,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,219.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,630.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,590.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,748.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,215.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,669.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,472.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,472.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.89,748.41,
COLONOSCOPY W/REMOVAL TUM POLYP LESIO,4010044,CDM,360,RC,,,outpatient,,,3015,1959.75,,2020.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,844.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,807.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,844.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2200.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2713.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,839.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2412,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2261.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,852.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,807.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,844.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2864.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,823.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2562.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1809,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,844.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1809,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,823.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,807.12,2864.25,
"ANOSCOPY;WITH BIOPSY, SINGLE OR MULTIPLE",4010052,CDM,360,RC,,,outpatient,,,1340.4,871.26,,898.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,375.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,358.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,375.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,978.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1206.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,373.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1072.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1005.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,379.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,358.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,375.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1273.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,366.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1139.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,804.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,375.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,804.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,366.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,358.83,1273.38,
COLONOSCOPY THROUGH STOMA,4018999,CDM,360,RC,,,outpatient,,,1295.1,841.82,,867.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,362.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,346.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,362.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,945.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1165.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,360.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1036.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,971.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,366.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,346.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,362.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1230.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,353.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1100.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,777.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,777.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,346.7,1230.35,
COLONOSCOPY WITH REMOVAL BY HOT FORCEPS,4019000,CDM,360,RC,,,outpatient,,,1295.1,841.82,,867.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,362.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,346.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,362.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,945.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1165.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,360.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1036.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,971.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,366.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,346.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,362.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1230.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,353.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1100.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,777.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,777.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,346.7,1230.35,
COLONOSCOPY W/BIOPSY,4019001,CDM,750,RC,,,outpatient,,,2331,1515.15,,1561.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,652.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,624.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,652.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1701.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2097.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,648.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1864.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1748.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,659.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,624.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,652.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2214.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,636.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1981.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1398.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,652.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1398.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,636.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,624.01,2214.45,
SIGMOIDOSCOPY W/REMOVAL TUMOR(S)POLYP(S),4019002,CDM,360,RC,,,outpatient,,,787.8,512.07,,527.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,575.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,709.02,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,219.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,630.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,590.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,748.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,215.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,669.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,472.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,472.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.89,748.41,
UPPER GI WITH BIOPSY,4019003,CDM,360,RC,,,outpatient,,,3476,2259.4,,2328.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,973.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,930.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,973.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2537.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3128.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,967.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2780.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2607,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,983.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,930.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,973.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3302.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,949.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2954.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2085.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,973.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2085.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,949.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,930.53,3302.2,
UPPER GI ENDO BY SNARE TECHNIQUE,4019035,CDM,360,RC,,,outpatient,,,1735.8,1128.27,,1162.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,464.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1267.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1562.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,483.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1388.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1301.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,490.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,464.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1649.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,473.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1475.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1041.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1041.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,473.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,464.67,1649.01,
UPPER GI ENDO W/REMOVAL BY HOT FORCEPS,4019036,CDM,360,RC,,,outpatient,,,1735.8,1128.27,,1162.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,464.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1267.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1562.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,483.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1388.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1301.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,490.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,464.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1649.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,473.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1475.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1041.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1041.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,473.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,464.67,1649.01,
SIGMOIDOSCOPY W OR W/O SPECIMEN,4019037,CDM,360,RC,,,outpatient,,,2390,1553.5,,1601.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,669.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,639.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,669.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1744.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2151,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,665.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1912,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1792.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,675.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,639.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,669.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2270.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,652.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2031.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1434,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,669.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1434,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,652.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,639.8,2270.5,
ROCEPHIN/NS IVPB: 2GM/100ML,4020026,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
CALCITRIOL (ROCALTROL) 0.25 MCG  CAPSULE,4020075,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
CALCIUM CARB +VIT D (OSCAL D) 500/200 TB,4020076,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LEVOTHYROXINE (SYNTHROID) TAB: 50MCG,4020077,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OXYCODONE (OXY-IR) 5MG TABLET  *CII*,4020090,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CARBIDOPA/LEVO (SINEMET) 25/100MG TAB,4020091,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MIRTAZAPINE (REMERON) TABLET: 30MG,4020092,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ALLOPURINOL (XYLOPRIM) 300MG TABLET,4020104,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ALLOPURINOL (ZYLOPRIM) TABLET: 100 MG,4020105,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
AMLODIPINE (NORVASC) 5 MG TABLET,4020107,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MEGESTROL (MEGACE) 800MG/20ML SUSP,4020109,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
GUAIFENESIN (ROBITUSSIN) SOLN:200MG/10ML,4020110,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
FLUoxetine (PROZAC) CAPSULE: 10MG,4020112,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
1/2 NS W/ 20MEQ KCL 1000ML,4020120,CDM,258,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
glyBURIDE MICRO (GLYNASE) TAB: 3MG,4020121,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ZIPRASIDONE (GEODON) 20MG CAP,4020156,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
HYDROXYUREA (HYDREA) CAPSULE: 500 MG,4020162,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
GUAIFENESIN ER (MUCINEX) TAB: 600 MG,4020163,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
WARFARIN (COUMADIN) TABLET: 1 MG,4020165,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
TOPIRAMATE (TOPAMAX) 25MG TABLET,4020172,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
LOVASTATIN (MEVACOR) 20MG TABL,4020176,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
TIMOLOL (TIMOPTIC) 0.5% OPTH. 5ML,4020181,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
RISPERIDONE (RISPERDAL) TAB:  0.25 MG,4020185,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
AMIKACIN 500MG INJ./ 100ML NORMAL SALINE,4020187,CDM,401,RC,,,outpatient,,,25.8,16.77,,17.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.91,24.51,
D5W 500ML,4020191,CDM,258,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
METHYLPREDNISOLONE (MEDROL) 4MG TABLET,4020192,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
RX FLUCONAZOLE 400MG/200ML PREMIX,4020193,CDM,636,RC,,,both,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
SODIUM BICARBONATE TAB: 650 MG,4020195,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
IRON POLYSAC COMPLEX (NU IRON) 150MG CP,4020196,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
VITAMIN B6 (PYRIDOXINE) 50 MG TABLET,4020198,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NYSTATIN (NYSTOP) POWDER 15 GM,4020201,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX ENOXAPARIN (LOVENOX) 100 MG INJ,4020202,CDM,636,RC,,,both,,,104,67.6,,69.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,93.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,83.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,88.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.84,98.8,
SENNA (SENOKOT) 8.6 MG TABLET,4020204,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
FERROUS SULFATE ELIXIR: 220MG/5ML,4020205,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MULTIVITAMIN ORAL LIQUID 5 ML,4020207,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
METFORMIN (GLUCOPHAGE) TAB: 850MG,4020209,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OMEGA-3 FATTY ACID (FISH OIL)1000MG CAP,4020210,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
MEMANTINE (NAMENDA) TABLET:  5 MG,4020214,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
SUCRALFATE (CARAFATE) SUSP  1GM/10ML,4020223,CDM,259,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
FLUCONAZOLE 10MG/ML SUSPENSION,4020231,CDM,391,RC,,,outpatient,,,25.8,16.77,,17.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.91,24.51,
ISONIAZID (INH) 300 MG TABLET,4020233,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CETIRIZINE (ZYRTEC) TABLET: 10MG,4020236,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
TERAZOSIN (HYTRIN) 5MG CAPSULE,4020237,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
BETAMETH/CLOTRIM (LOTRISONE) CREAM 15GM,4020246,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
OXYBUTYNIN (DITROPAN) TAB: 5MG,4020247,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OYSTER SHELL CALCIUM (OSCAL) TAB: 500MG,4020250,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
TRACE MINERAL (MULTITRACE-5 CONC) 1ML IJ,4020254,CDM,250,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
DIVALPROEX (DEPAKOTE) SPRINKLE: 125MG,4020257,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
CYANOCOBALAMIN (VIT B12) TABLET: 1000mcg,4020260,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ISOSORBIDE DINITRATE (ISORDIL) 10MG TB,4020268,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
HYDROcodon/HOMATROP (HYCODAN) SYRUP: 5ML,4020270,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
NIACIN ER (NIASPAN) 250 MG CAPSULES,4020271,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ALISKIREN (TEKTURNA) 150MG TABLET,4020274,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
POTASSIUM ACETATE (2MEQ/ML) 20ML SDV,4020276,CDM,250,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
POTASSIUM PHOSPHATE 66MEQ/45MMOL/15ML IJ,4020277,CDM,250,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
POTASSIUM CHLORIDE (2mEQ/ML) 10ML SDV,4020283,CDM,250,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
PREDNISONE (DELTASONE) TABLET: 5 MG,4020284,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
SODIUM CHLORIDE 2.5 MEQ/ML INJ *CONC*,4020286,CDM,250,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
BUPIVACAINE (MARCAINE) 0.5% W/EPI INJ,4020288,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
HYDROCERIN (EUCERIN) LOTION 8 OZ,4020289,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
MELOXICAM (MOBIC) 7.5MG TAB,4020294,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
CHLORASEPTIC THROAT SPRAY:  6OZ,4020295,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
CARBIDOPA/LEVO (SINEMET) 25/250MG TAB,4020297,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
DAKINS 0.125% SOLN (1/4 STRENGTH),4020299,CDM,637,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
DICLOFENAC (VOLTAREN) ER TABLET: 75MG,4020300,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
CITALOPRAM (CELEXA) TABLET: 20MG,4020305,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
NITROGLYCERIN (NITRODUR) 0.2MG/HR PATCH,4020307,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
CHLORHEXIDINE 4% (HIBICLENS) SCRUB: 4OZ,4020308,CDM,637,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
POVIDONE-IODINE (BETADINE) SOLUTION 4 OZ,4020309,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
SOTALOL (SORINE/BETAPACE) 80MG TABLET,4020310,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
CEFDINIR (OMNICEF) CAPSULE: 300MG,4020311,CDM,637,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
ROPINIROLE (REQUIP) 0.5 MG TABLETS,4020315,CDM,637,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
PROSOURCE LIQUID 30 ML,4020316,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
CALMOSEPTINE OINTMENT: 2.5 OZ TUBE,4020323,CDM,637,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
VERAPAMIL HCL (CALAN) 40 MG TABLETS,4020326,CDM,637,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
ST TREATMENT SPEECH INDIVIDUAL,4030000,CDM,440,RC,,,outpatient,,,261.5,169.98,,175.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,73.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,235.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,72.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,209.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,196.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,73.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,248.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,71.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,222.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,156.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70,248.43,
ST EVALUATION SPEECH FLUENCY,4030001,CDM,444,RC,,,outpatient,,,204.6,132.99,,137.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,57.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,149.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,184.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,56.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,163.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,153.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,57.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,54.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,194.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,55.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,173.91,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,122.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,122.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.77,194.37,
ST EVALUATION SPEECH SOUND PRDUCTION,4030002,CDM,444,RC,,,outpatient,,,167.1,108.62,,111.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,150.39,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,46.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,133.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,125.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,158.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,142.04,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,100.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.73,158.75,
ST EVALUATION SPEECH SOUND PROD W EVAL,4030003,CDM,444,RC,,,outpatient,,,393,255.45,,263.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,110.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,110.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,353.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,109.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,314.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,294.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,111.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,105.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,110.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,373.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,107.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,334.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,235.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,235.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,105.21,373.35,
ST BEHAVIORAL and QUALITATIVE ANALYSIS,4030004,CDM,440,RC,,,outpatient,,,173.4,112.71,,116.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,48.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,156.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,48.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,138.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,130.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,46.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,47.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,147.39,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,104.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.42,164.73,
ST TREATMENT SWALLOWING DYSFUNCTION,4030005,CDM,440,RC,,,outpatient,,,183.5,119.28,,122.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,165.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,51.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,146.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,137.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,49.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,174.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,50.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,110.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.12,174.33,
ST EVALUATION FOR PRESCRIPT SPEECH DEV,4030006,CDM,444,RC,,,outpatient,,,232.2,150.93,,155.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,65.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,208.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,64.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,185.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,174.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,65.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,62.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,220.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,63.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,197.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,139.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,139.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.16,220.59,
ST EVAL  PRESCRIPT SPCH DEV ea addL 30,4030007,CDM,444,RC,,,outpatient,,,96.3,62.6,,64.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,86.67,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,77.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,72.23,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.78,91.49,
ST THERAPEUTIC SERVICES SPEECH DEVICE,4030008,CDM,440,RC,,,outpatient,,,200.4,130.26,,134.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,180.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,160.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,150.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,120.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.65,190.38,
ST EVALUATION ORAL and PHARYNGEAL SWALLO,4030009,CDM,444,RC,,,outpatient,,,99,64.35,,66.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.5,94.05,
ST MOTION FLUROSCOPIC EVAL SWALL FUNCT,4030010,CDM,444,RC,,,outpatient,,,164.7,107.06,,110.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,131.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.47,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,44.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,98.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.09,156.47,
ST EVAL AUDITORY REHAB STATUS 1st h,4030011,CDM,444,RC,,,outpatient,,,141,91.65,,94.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.75,133.95,
ST EVAL  AUDITORY REHAB EA ADDL 15MIN,4030012,CDM,444,RC,,,outpatient,,,141,91.65,,94.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.75,133.95,
ST ASSESSMENT APHASIA WITH INTERP,4030013,CDM,444,RC,,,outpatient,,,183,118.95,,122.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,164.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,146.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,137.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.99,173.85,
ST DEVELOP TESTING WITH INTERP REPORT,4030014,CDM,918,RC,,,outpatient,,,225.3,146.45,,150.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,63.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,180.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.98,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,214.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,191.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,135.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.31,214.04,
ST STANDARIZED COGNITIVE TESTING PER HR,4030015,CDM,918,RC,,,outpatient,,,205.2,133.38,,137.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,57.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,149.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,184.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,57.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,164.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,153.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,58.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,54.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,194.94,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,56.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,174.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,123.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.93,194.94,
ST DEVELOPMENT COGNITIVE SKILLS EA 15min,4030016,CDM,440,RC,,,outpatient,,,221,143.65,,148.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,61.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,198.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,61.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,176.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,165.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,62.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,59.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,209.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,60.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,187.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,59.16,209.95,
ST SENSORY INTEGRATIVE TECH EA 15min,4030017,CDM,440,RC,,,outpatient,,,52.8,34.32,,35.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.13,50.16,
ST SELFCARE/HOME MANAGE TRAINING EA 15m,4030018,CDM,440,RC,,,outpatient,,,66.5,43.23,,44.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.8,63.18,
ST DEVELOP TESTING PER STANDARDIZED FOR,4030019,CDM,918,RC,,,outpatient,,,56.21,36.54,,37.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.97,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.16,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.05,53.4,
ST G8996 SWALLOW FUNCT LIMIT CURREN,4030020,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G8997 SWALLOW  FUNCT LIMIT PROJEC,4030021,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G8998 SWALLOW FUNCT LIMIT DISCHA,4030022,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G8999 MOTOR SPEECH FUNCT LIMIT CURRE,4030023,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9158 MOTOR SPEECH FUNCT LIMIT DISCH,4030024,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9159 SPOKE LANG COMP FUNT LIMIT CUR,4030025,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9160 SPOKE LANG COMP FUNT LIMIT PROJ,4030026,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9161 SPOKE LANG COMP FUNT LIMIT DISC,4030027,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9162 SPOKE LAN EXPRES FUNT LIMIT CUR,4030028,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9163 SPOKE LAN EXPRES FUNT LIMIT PRO,4030029,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9164 SPOKE LAN EXPRESS FUN LIMIT DIS,4030030,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9165 ATTENTION FUNCT LIMIT CURRENT,4030031,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9166 ATTENTION FUNCT LIMIT PROJECT,4030032,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9167 ATTENTION FUNCT LIMIT DISCHARG,4030033,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9168 MEMORY FUNCT LIMIT CURR,4030034,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9169 MEMORY FUNCT LIMIT PROJECTED,4030035,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9170 MEMORY FUNCT LIMIT DISCHARGE,4030036,CDM,440,RC,,,outpatient,,,0.09,0.06,,0.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.09,
ST G9171 VOICE FUNCT LIMIT CURRENT,4030037,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9172 VOICE FUNCT LIMIT PROJECT,4030038,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9173 VOICE FUNCT LIMIT DISCHARGE,4030039,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9174 OTSPCH LAN PATH FUNC LIMIT CURR,4030040,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9175 OTSPCH LANG PATH FUNC LIM PROJ,4030041,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9176 OT SPCH LNG PAT FUN LIMIT DISCH,4030042,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
ST G9186 MOTOR SPEECH FUNCT LIMIT PROJ,4030043,CDM,440,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
CERVICAL LYMPHADENECTOMY,4038720,CDM,360,RC,,,outpatient,,,3408.9,2215.79,,2283.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,954.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,912.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,954.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2488.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3068.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,949.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2727.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2556.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,964.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,912.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,954.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3238.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,930.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2897.57,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2045.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,954.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2045.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,912.56,3238.46,
ST CIS SPEECH LANG THERAPY,4092507,CDM,440,RC,,,outpatient,,,261.5,169.98,,175.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,73.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,235.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,72.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,209.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,196.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,73.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,248.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,71.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,222.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,156.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70,248.43,
ST CIS EVALUATION SPEECH SOUND,4092523,CDM,440,RC,,,outpatient,,,393,255.45,,263.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,110.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,110.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,353.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,109.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,314.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,294.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,111.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,105.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,110.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,373.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,107.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,334.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,235.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,235.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,105.21,373.35,
ST CIS TREATMENT SWALLOW DYSFUNC ORL FEE,4092526,CDM,440,RC,,,outpatient,,,183.5,119.28,,122.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,165.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,51.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,146.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,137.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,49.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,174.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,50.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,110.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.12,174.33,
ST CIS EVAL ORAL PHARYNGEAL SWALLOW FUNC,4092610,CDM,440,RC,,,outpatient,,,99,64.35,,66.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.5,94.05,
ST CIS ASSESSMENT APAHASIA,4096105,CDM,440,RC,,,outpatient,,,183,118.95,,122.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,164.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,146.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,137.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.99,173.85,
ST CIS DEVELOP COGNITIVE SKILLS,4097532,CDM,440,RC,,,outpatient,,,81,52.65,,54.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.68,76.95,
ST CIS SENSORY INTEGRATIVE TECHNI,4097533,CDM,440,RC,,,outpatient,,,52.8,34.32,,35.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.13,50.16,
RX TETANUS/DIPTH (Td; Tenivac) INJ 0.5ML,4120005,CDM,250,RC,,,outpatient,,,64,41.6,,42.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.13,60.8,
RX TRIAMCIN ACET (KENALOG-40) 40MG/ML IJ,4120010,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
"RX EPOETIN ALF INJ NON ESRD: 40,000 UNIT",4120031,CDM,636,RC,,,both,,,638,414.7,,427.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,170.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,319,50,,,percent of total billed charges,50% of billed charges for High Cost Drugs,574.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,177.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,510.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,478.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,180.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,170.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,606.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,174.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,542.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,382.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,382.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.79,606.1,
RX DEXAMETHASONE NA 20MG/5ML INJ MDV,4120040,CDM,636,RC,,,both,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
TERBUTALINE (BRETHINE) 1MG/ML SDV,4120048,CDM,250,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
RX AMIODARONE HCL 150 MG INJ (5 X 30MG),4120049,CDM,636,RC,,,both,,,7.6,4.94,,5.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.22,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.03,7.22,
CEFTRIAXONE NA (ROCEPHIN) INJ: 250MG,4120050,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX CEFTRIAXONE NA (ROCEPHIN) INJ: 1GM,4120052,CDM,636,RC,,,both,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
METHYLPRD ACE (DEPO MEDROL) 80MG/ML SDV,4120061,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX DICYCLOMINE (BENTYL) INJ: 20MG/2ML,4120065,CDM,636,RC,,,both,,,158,102.7,,105.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,142.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,126.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,118.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,44.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,42.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,43.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.3,150.1,
LEVOFLOXACIN/NS PREMIX IVPB: 750MG/150ML,4120067,CDM,250,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
DULoxetine (CYMBALTA) CAPSULE: 30MG,4120069,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
DIGOXIN (LANOXIN) INJECTION: 500MCG/2ML,4120072,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX DIPHENHYDRAMINE (BENADRYL) 50MG/ML IJ,4120080,CDM,636,RC,,,both,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
LIDOCAINE/PRILOCAINE (EMLA) CREAM 30GM,4120083,CDM,637,RC,,,outpatient,,,53,34.45,,35.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.19,50.35,
GLUCAGON (GLUCAGEN) INJECTION: 1MG,4120087,CDM,636,RC,,,both,,,418,271.7,,280.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,111.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.9,397.1,
LIDOCAINE/PRILOCAINE (EMLA) CREAM 5GM,4120089,CDM,637,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
RX HALOPERIDOL INJECTION: 5MG/ML,4120090,CDM,636,RC,,,both,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX ENOXAPARIN (LOVENOX) 30 MG INJ,4120097,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
RX ENOXAPARIN (LOVENOX) 80 MG INJ,4120099,CDM,636,RC,,,both,,,68,44.2,,45.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.2,64.6,
RX ENOXAPARIN (LOVENOX) 40 MG INJ,4120100,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
RX ENOXAPARIN (LOVENOX) 60 MG INJ,4120101,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
RX HEPARIN LOCK FLUSH INJ: 500UNITS/5ML,4120102,CDM,636,RC,,,both,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
SODIUM CHLORIDE 0.9% FLUSH SYRINGE: 10ml,4120105,CDM,272,RC,,,outpatient,,,13.8,8.97,,9.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.42,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.69,13.11,
RX SUMATRIPTAN (IMITREX) INJ:  6 MG,4120115,CDM,636,RC,,,both,,,70,45.5,,46.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,63,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,52.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,59.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.74,66.5,
RX KETOROLAC (TORADOL) INJ: 30 MG/ML,4120120,CDM,636,RC,,,both,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
FUROSEMIDE (LASIX) INJECTION: 20MG/2ML,4120130,CDM,250,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
FUROSEMIDE (LASIX) INJECTION: 40MG/4ML,4120131,CDM,250,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
FUROSEMIDE (LASIX) INJECTION: 100MG/10ML,4120132,CDM,250,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
RX LORAZEPAM (ATIVAN) INJECTION: 2MG/ML,4120140,CDM,636,RC,,,both,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
MEPERIDINE (DEMEROL) INJECTION: 25MG/ML,4120150,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
MEPERIDINE HCL (DEMEROL) 50 MG/ML INJ,4120151,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
ATROPINE 0.4 MG/ML SDV,4120155,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX MIDAZOLAM (VERSED) *2MG/2ML* INJ,4120161,CDM,636,RC,,,both,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
RX MAGNESIUM SULF 1GM/2ML SDV,4120165,CDM,636,RC,,,both,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX MAGNESIUM SULFATE 5GM ABBJ,4120166,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
BUPIVACAINE 0.75% SPINAL (MARCAINE) INJ,4120168,CDM,250,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
MORPHINE SULFATE INJECTION: 2MG/ML,4120170,CDM,250,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
RX SUCCINYLCHOLINE (ANECTINE) 200MG INJ,4120171,CDM,636,RC,,,both,,,66,42.9,,44.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.67,62.7,
MORPHINE SULFATE INJECTION: 10MG/ML,4120173,CDM,250,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX PROMETHAZINE (PHENERGAN) INJ: 25MG/ML,4120300,CDM,636,RC,,,both,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
"RX EPOETIN ALF INJ NON ESRD:10,000 UNIT",4120301,CDM,636,RC,,,both,,,176,114.4,,117.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,158.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,140.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,132,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,47.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,48.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,149.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.12,167.2,
RX METOCLOPRAMIDE (REGLAN) INJ: 10MG/2ML,4120401,CDM,636,RC,,,both,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
RX FENTANYL (SUBLIMAZE) INJ: 100MCG/2ML,4120450,CDM,636,RC,,,both,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
RX METHYLPREDNISOLONE SOD SUCC 500MG INJ,4120504,CDM,636,RC,,,both,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX METHYLPREDNISOLONE SOD SUCC INJ: 40MG,4120505,CDM,636,RC,,,both,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
RX METHYLPREDNISOLONE SOD SUCC INJ:125MG,4120506,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
HYDROCORTISONE (SOLU-CORTEF) INJ:100MG,4120507,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
DIAZEPAM (VALIUM) INJECTION: 10MG/2ML,4120600,CDM,250,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX CYANOCOBALAMIN (V B12) INJ:1000MCG/ML,4120840,CDM,636,RC,,,both,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX ONDANSETRON (ZOFRAN) INJ: 4MG/2ML,4120952,CDM,636,RC,,,both,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
RX TENECTEPLASE (TNKase) INJECTION: 50MG,4122000,CDM,636,RC,,,both,,,4064,2641.6,,2722.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1137.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1087.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1137.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2032,50,,,percent of total billed charges,50% of billed charges for High Cost Drugs,3657.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1131.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3251.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3048,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1149.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1087.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1137.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3860.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1109.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3454.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2438.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1137.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2438.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1109.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1087.93,3860.8,
VANCOMYCIN HCL (VANCOCIN) 1GM PWDVL,4122050,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
"RX EPOETIN ALF INJ NON ESRD:20,000 UNIT",4130027,CDM,636,RC,,,both,,,336,218.4,,225.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,94.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,245.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,302.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,93.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,268.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,252,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,95.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,319.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,91.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,285.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,201.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,201.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.95,319.2,
IM SUB Q INJECTION,4150013,CDM,514,RC,,,outpatient,,,240.5,156.33,,161.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,175.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,216.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,66.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,192.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,180.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,68.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,64.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,228.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,65.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,204.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,144.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.38,228.48,
RX AMPICILLIN 1gm INJECTION,4160030,CDM,636,RC,,,both,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
FOSPHENYTOIN (cereBYX) INJ: 500MG/10ML,4160055,CDM,636,RC,,,both,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
RX CEFTRIAXONE NA (ROCEPHIN) INJ: 500MG,4162001,CDM,636,RC,,,both,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
RX CEFTRIAXONE NA (ROCEPHIN) INJ: 2GM,4162003,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
RX PANTOPRAZOLE (PROTONIX) 40 MG INJ,4162030,CDM,636,RC,,,both,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX LEVOFLOXACIN (LEVAQUIN) 250MG PREMIX,4163000,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
RX LEVOFLOXACIN (LEVAQUIN) 500MG PREMIX,4163001,CDM,636,RC,,,both,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX GENTAMICIN INJECTION: 80MG/2ML,4164005,CDM,636,RC,,,both,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
RX AZITHROMYCIN (ZITHROMAX) PWVL 500MG,4164500,CDM,636,RC,,,both,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
RX PIPERACILL/TAZOB (ZOSYN) INJ: 3.375GM,4165000,CDM,636,RC,,,both,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
RX AMPICILLIN/SULBACT (UNASYN) 1.5GM INJ,4166000,CDM,636,RC,,,both,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
ABDOMINAL BINDER L,4180001,CDM,270,RC,,,outpatient,,,21.6,14.04,,14.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.78,20.52,
ADAPTIC DRESSING,4180006,CDM,270,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
ADHESIVE REMOVER HOLLISTER,4180007,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
HAND RESTRAINTS,4180009,CDM,270,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
AIRWAY SIZE 0,4180010,CDM,270,RC,,,outpatient,,,11.4,7.41,,7.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.05,10.83,
AIRWAY SIZE 1,4180011,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
AIRWAY SIZE 2,4180012,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
AIRWAY SIZE 3,4180013,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
AIRWAY SIZE 4,4180014,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
AIRWAY SIZE 5,4180015,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
AIRWAY SIZE 6,4180016,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
AUTO SUTURES,4180019,CDM,270,RC,,,outpatient,,,109.8,71.37,,73.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,98.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,87.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.39,104.31,
BALLOON DILATOR,4180020,CDM,270,RC,,,outpatient,,,525.98,341.89,,352.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,147.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,147.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,383.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,473.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,146.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,420.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,394.49,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,148.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,140.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,147.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,499.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,143.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,447.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,315.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,315.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,143.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.8,499.68,
LMA #2,4180021,CDM,270,RC,,,outpatient,,,15.3,9.95,,10.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.77,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.1,14.54,
LMA #3,4180022,CDM,270,RC,,,outpatient,,,14.7,9.56,,9.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.94,13.97,
LMA #4,4180023,CDM,270,RC,,,outpatient,,,8.7,5.66,,5.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.83,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.33,8.27,
LMA #5,4180024,CDM,270,RC,,,outpatient,,,14.7,9.56,,9.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.23,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.94,13.97,
GLIDE SCOPE BLADE DISPOSABLE,4180025,CDM,270,RC,,,outpatient,,,41,26.65,,27.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.98,38.95,
BEDPAN REGULAR,4180030,CDM,270,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
BETADINE HELAFOAM SOLUTION,4180031,CDM,270,RC,,,outpatient,,,36.6,23.79,,24.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.8,34.77,
BIOPSY NEEDLE DISP (TRU CUT),4180032,CDM,270,RC,,,outpatient,,,42,27.3,,28.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.24,39.9,
BLADDER CARE TRAY 16 FR,4180033,CDM,270,RC,,,outpatient,,,9.5,6.18,,6.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.54,9.03,
BLADDER CARE TRAY 18 FR,4180034,CDM,270,RC,,,outpatient,,,15.5,10.08,,10.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.15,14.73,
BONE PLATE,4180039,CDM,278,RC,,,both,,,34.2,22.23,,22.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.78,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.49,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.07,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.16,32.49,
BONE SCREW,4180040,CDM,278,RC,,,both,,,37.2,24.18,,24.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.96,35.34,
BONE STAPLE,4180041,CDM,278,RC,,,both,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
BILE BAG,4180044,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
BAKER TUBE,4180045,CDM,270,RC,,,outpatient,,,266.4,173.16,,178.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,74.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,194.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,239.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,74.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,213.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,199.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,75.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,71.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,253.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,72.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,226.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,159.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,159.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.32,253.08,
CATHETER FOLEY 12 FR 5CC,4180046,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
BILLIARY CATHETER8FOGARTY9,4180048,CDM,270,RC,,,outpatient,,,141,91.65,,94.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.75,133.95,
CATHETER KIT FOLEY 5CC 26FR,4180049,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER 3 WAY,4180050,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER FOLEY 8 FR,4180051,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER FOLEY 10 FR,4180052,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER FOLEY 14 FR,4180053,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER FOLEY 16 FR,4180054,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER FOLEY 18 FR,4180055,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER FOLEY 26 FR,4180056,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER FOLEY 28 FR,4180057,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER FOLEY 30 FR,4180058,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT 7604 15 FR,4180059,CDM,270,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
CATHETER KIT FOLEY 5CC 12 F,4180060,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT FOLEY 5CC 14 F,4180061,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT FOLEY 5CC 16 F,4180062,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT FOLEY 5CC 18 F,4180063,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT FOLEY 5CC FR 2,4180064,CDM,270,RC,,,outpatient,,,41.7,27.11,,27.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.53,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.28,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.16,39.62,
CATHETER KIT FOLEY 30 CC 14,4180065,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT FOLEY 30 CC 16,4180066,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT FOLEY 30 CC 18,4180067,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT FOLEY 30CC 20,4180068,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT FOLEY 30 CC 24,4180069,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER PROSTATE (BARDEX),4180071,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
HANDTROL PLUS,4180078,CDM,270,RC,,,outpatient,,,48.5,31.53,,32.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.98,46.08,
GROUND-IT PAD,4180079,CDM,270,RC,,,outpatient,,,52.8,34.32,,35.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.13,50.16,
CHUCK IT HANDLE & CORD,4180080,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
CLEANSERS (SORBIES),4180082,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
CLOSED DRAINAGE SET,4180083,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
CVP TRANSFUSOR,4180086,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
CYSTOSCOPE PACK,4180087,CDM,270,RC,,,outpatient,,,22.8,14.82,,15.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.1,21.66,
CATHETER SWAN GANZ,4180088,CDM,270,RC,,,outpatient,,,164.4,106.86,,110.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,147.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,131.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,44.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,139.74,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,98.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.01,156.18,
CATHETER NASAL BALLOON,4180089,CDM,270,RC,,,outpatient,,,73.8,47.97,,49.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,66.42,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,59.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.76,70.11,
CATHETER FOGARTY EMBOLECTOM,4180090,CDM,270,RC,,,outpatient,,,100.2,65.13,,67.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.82,95.19,
CIDEX DISENFECIANT,4180091,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
CATHETER FOLEY-COUDE 16 FR.,4180092,CDM,270,RC,,,outpatient,,,15.33,9.96,,10.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.26,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.1,14.56,
CYSTOCATH,4180093,CDM,270,RC,,,outpatient,,,63,40.95,,42.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,56.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.87,59.85,
CATHETER 3 WAY 30 CC 20 FR,4180094,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER 3 WAY 30 CC 24 FR,4180095,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CATHETER KIT FOLEY 5 CC 24,4180096,CDM,270,RC,,,outpatient,,,120.12,78.08,,80.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,108.11,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90.09,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.16,114.11,
CATHETER KIT FOLEY 5 CC 30,4180097,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CAUTERY,4180098,CDM,270,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
CVP MONITOR,4180099,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
"CATHETER, PEZZER(MUSHROOM)",4180102,CDM,270,RC,,,outpatient,,,29.4,19.11,,19.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.87,27.93,
DENTAL ALLOY TYTIN,4180110,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
DENTURE KIT,4180120,CDM,270,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
DERMATONE HEAD (DISP),4180121,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
DRAPES GENERAL SURGERY,4180126,CDM,637,RC,,,outpatient,,,230,149.5,,154.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,64.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,64.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,207,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,64.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,184,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,172.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,65.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,61.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,64.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,218.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,62.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,195.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.57,218.5,
DRAPES GOWN & TOWEL,4180127,CDM,272,RC,,,outpatient,,,24,15.6,,16.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.42,22.8,
DRAPES LAP III,4180129,CDM,272,RC,,,outpatient,,,331.24,215.31,,221.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,92.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,241.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,298.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,92.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,264.99,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,248.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,93.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,88.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,314.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,90.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,281.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,198.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.75,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,198.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,88.67,314.68,
DRAPES ORTHO MINOR PACK,4180132,CDM,637,RC,,,outpatient,,,169,109.85,,113.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,152.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,47.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,135.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,126.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,143.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.24,160.55,
ESOPHAGEAL BALLOON DILATOR,4180133,CDM,270,RC,,,outpatient,,,450,292.5,,301.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,126,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,126,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,328.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,405,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,125.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,360,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,337.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,127.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,120.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,126,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,427.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,122.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,382.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,120.47,427.5,
DRAPES STERILE SMALL,4180142,CDM,637,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
DRAPES STERILE MEDIUM,4180143,CDM,637,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
DRAPES STERILE LARGE,4180144,CDM,637,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
TELFA 4 X 3,4180145,CDM,270,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
DRESSING TRAY MAJOR,4180148,CDM,272,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
DRESSING TRAY MINOR,4180149,CDM,637,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
DECUPITUS PAD CVB15,4180150,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
DECUPITUS PAD CVB1 7,4180151,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
DRESSING PLAIN 2 X 2,4180152,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
DERMA CARRIES II,4180154,CDM,270,RC,,,outpatient,,,69,44.85,,46.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,62.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,55.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.47,65.55,
ELECTRODES CARDIAC MONITOR,4180161,CDM,270,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
ENEMA SYRINGE (INFANT),4180165,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
EPIDURAL ANESTHESIA TRAY,4180167,CDM,637,RC,,,outpatient,,,76,49.4,,50.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,68.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,60.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.35,72.2,
EPIDURAL CANNULA,4180168,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
EYE PAD OVAL,4180170,CDM,270,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
FOAMASEPTIC 6 OZ,4180185,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
FEEDING TUBES EACH,4180188,CDM,270,RC,,,outpatient,,,34.8,22.62,,23.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.32,33.06,
ATERIAL MONITOR DAILY,4180191,CDM,270,RC,,,outpatient,,,138,89.7,,92.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,124.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,110.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,103.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,36.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,117.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,82.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.94,131.1,
GRAFT KNIT BIFRACTED CH1315,4180211,CDM,270,RC,,,outpatient,,,333,216.45,,223.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,299.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,92.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,266.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,249.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,283.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.14,316.35,
GRAFT KNIT BIFRACTED CH1315,4180212,CDM,270,RC,,,outpatient,,,333,216.45,,223.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,299.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,92.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,266.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,249.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,283.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.14,316.35,
GRAFT STRAIGHT ARTERIAL CH1,4180215,CDM,270,RC,,,outpatient,,,333,216.45,,223.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,299.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,92.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,266.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,249.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,283.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.14,316.35,
GRAFT STRAIGHT ARTERIAL CH1,4180216,CDM,270,RC,,,outpatient,,,333,216.45,,223.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,299.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,92.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,266.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,249.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,283.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.14,316.35,
GRAFT STRAIGHT ARTERIAL CH1,4180217,CDM,270,RC,,,outpatient,,,333,216.45,,223.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,299.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,92.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,266.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,249.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,283.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.14,316.35,
GRAFT ST WOVEN 8MM,4180218,CDM,270,RC,,,outpatient,,,306.6,199.29,,205.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,85.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,223.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,275.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,85.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,245.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,229.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,86.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,82.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,83.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,260.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,183.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,183.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,82.08,291.27,
GORTEX 6mm x 70cm,4180219,CDM,270,RC,,,outpatient,,,841.2,546.78,,563.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,235.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,225.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,235.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,614.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,757.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,234.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,672.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,630.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,237.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,225.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,235.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,799.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,229.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,715.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,504.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,235.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,504.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,225.19,799.14,
GORTEX 6mm x 60cm,4180220,CDM,270,RC,,,outpatient,,,787.8,512.07,,527.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,575.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,709.02,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,219.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,630.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,590.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,748.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,215.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,669.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,472.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,220.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,472.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.89,748.41,
HEATING PAD DVO THERM 12 X,4180230,CDM,270,RC,,,outpatient,,,43.2,28.08,,28.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.72,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.56,41.04,
HEATING PAD DVO TH ERM 18 X,4180231,CDM,270,RC,,,outpatient,,,55.2,35.88,,36.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.78,52.44,
HEEL PROTECTOR,4180232,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
HEMOVAC MEDIUM,4180233,CDM,270,RC,,,outpatient,,,74.4,48.36,,49.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,66.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,59.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.83,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.92,70.68,
HEMOVAC LARGE,4180234,CDM,270,RC,,,outpatient,,,57.6,37.44,,38.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.96,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.42,54.72,
INVALID CUSHION,4180251,CDM,270,RC,,,outpatient,,,55.8,36.27,,37.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.94,53.01,
KLING 6 INCH,4180276,CDM,270,RC,,,outpatient,,,3.5,2.28,,2.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.94,3.33,
LACERATION PACK,4180280,CDM,270,RC,,,outpatient,,,14.4,9.36,,9.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.85,13.68,
LAP PAD (SOF-WIK) 5 PACK,4180281,CDM,270,RC,,,outpatient,,,36.6,23.79,,24.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.8,34.77,
LAP SPONGE (KERLIX) 5 TRAY,4180282,CDM,270,RC,,,outpatient,,,22.8,14.82,,15.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.1,21.66,
LEMON GLYCERINE SWABS,4180283,CDM,270,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
LEVINE TUBE 18 FR DISP,4180286,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
LIPPES LOOP,4180287,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
LOCKING SCREW,4180288,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
PROLENE MESH PMS,4180300,CDM,270,RC,,,outpatient,,,191.4,124.41,,128.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,53.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,139.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,172.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,53.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,153.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,143.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,54.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,51.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,52.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,162.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,114.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.24,181.83,
PROLENE MESH SPM-149,4180303,CDM,270,RC,,,outpatient,,,202.2,131.43,,135.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,181.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,56.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,161.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,151.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,57.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,54.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,192.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,55.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,171.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,121.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.13,192.09,
PROLENE MESH SPM-35,4180304,CDM,270,RC,,,outpatient,,,184.2,119.73,,123.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,165.78,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,51.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,147.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,138.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,52.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,49.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,174.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,50.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,156.57,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,110.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.31,174.99,
MEDICAL ADHESIVE HOLLISTER,4180305,CDM,270,RC,,,outpatient,,,36.6,23.79,,24.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.8,34.77,
METHIOLATE SPRAY,4180306,CDM,270,RC,,,outpatient,,,22.8,14.82,,15.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.1,21.66,
MID-STREAM CLEAN CATCH UNIT,4180309,CDM,270,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
NASOGASTRIC TUBES,4180319,CDM,270,RC,,,outpatient,,,189,122.85,,126.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,52.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,137.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,170.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,52.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,151.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,141.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,53.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,50.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,179.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,51.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,160.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.6,179.55,
NEBULIZER AEROSOL DISPOSABL,4180324,CDM,270,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
OSTOMY GASKET 4 1/2 INCHES,4180337,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
PEANUT SPONGES,4180352,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
PERITONEAL DIALYSIS TRAY,4180355,CDM,270,RC,,,outpatient,,,57.6,37.44,,38.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.96,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.42,54.72,
PREP TRAY,4180356,CDM,270,RC,,,outpatient,,,11.4,7.41,,7.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.05,10.83,
PLURA-VAC,4180357,CDM,270,RC,,,outpatient,,,199.2,129.48,,133.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,55.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,179.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,159.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,149.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,189.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,169.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,119.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,119.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.33,189.24,
ROTATING TOURNIQUET,4180369,CDM,270,RC,,,outpatient,,,36.6,23.79,,24.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.8,34.77,
RAZOR STERILE (DISP),4180370,CDM,270,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
SPONGES 4 X 4 STERILE 10 PK,4180372,CDM,270,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
SEPITSOL 8 OZ,4180381,CDM,270,RC,,,outpatient,,,13.2,8.58,,8.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.53,12.54,
SLIDING KEN NAIL,4180385,CDM,278,RC,,,both,,,211.2,137.28,,141.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,59.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,59.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,154.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,190.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,58.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,168.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,158.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,59.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,56.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,59.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,200.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,57.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,179.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,126.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.54,200.64,
SMITH PETERSON NAIL,4180386,CDM,278,RC,,,both,,,211.2,137.28,,141.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,59.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,59.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,154.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,190.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,58.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,168.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,158.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,59.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,56.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,59.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,200.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,57.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,179.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,126.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.54,200.64,
SPECIMEN CONTAINER STERILE,4180388,CDM,270,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
SPINAL ANESTHIA TRAY,4180389,CDM,637,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
STINMAN PIN,4180393,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
STOMA IRRIGATION DRAIN,4180394,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
STOMA POUGH DRAINABLE,4180395,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
SUCTION CATHETER 18 FR,4180398,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
SUCTION TRAY W/14 FR CATHET,4180399,CDM,270,RC,,,outpatient,,,1.5,0.98,,1.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.4,1.43,
SURGIPAD 5x9,4180402,CDM,270,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
SUTURE REMOVAL KIT,4180403,CDM,270,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
SKIN PREP STOMA,4180407,CDM,270,RC,,,outpatient,,,23.4,15.21,,15.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.26,22.23,
SKIN STAPLE REMOVER DISP,4180408,CDM,270,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
SKIN STAPLER,4180409,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
SUTURE TRAY ER MINOR,4180413,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
SUTURE TRAY ER MAJOR,4180414,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
SUCTION CANNISTER,4180415,CDM,270,RC,,,outpatient,,,19,12.35,,12.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.09,18.05,
STAINLESS SPRING GUIDE,4180416,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
TED STOCKING SM PR KNEE,4180420,CDM,270,RC,,,outpatient,,,96.46,62.7,,64.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,86.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,77.17,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,72.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.82,91.64,
TED STOCKING MED PR THIGH,4180421,CDM,270,RC,,,outpatient,,,31.8,20.67,,21.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.51,30.21,
TED STOCKING LG PR,4180422,CDM,270,RC,,,outpatient,,,31.8,20.67,,21.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.51,30.21,
TED STOCKING EX LG PR,4180423,CDM,270,RC,,,outpatient,,,31.8,20.67,,21.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.51,30.21,
THORACIC CATH 32FR,4180429,CDM,270,RC,,,outpatient,,,55.2,35.88,,36.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.78,52.44,
THORACIC CATH 24FR,4180430,CDM,270,RC,,,outpatient,,,55.2,35.88,,36.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.78,52.44,
THORACIC CATH 28G,4180432,CDM,270,RC,,,outpatient,,,49.8,32.37,,33.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.33,47.31,
TINCTURE OF BENZOIN SPRAY,4180433,CDM,270,RC,,,outpatient,,,21.6,14.04,,14.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.78,20.52,
TOPPER SPONGE,4180435,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
TOURNIQUET REDI-CUFF,4180436,CDM,270,RC,,,outpatient,,,36.6,23.79,,24.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.8,34.77,
TRACHEOSTOMY TUBE ASSORTED,4180437,CDM,270,RC,,,outpatient,,,78,50.7,,52.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,70.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,62.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,58.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,66.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.88,74.1,
TRACH CARE KIT,4180438,CDM,270,RC,,,outpatient,,,5,3.25,,3.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,4.75,
TRACHEOSTOMY MASK,4180439,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
URETHRAL CATHETER,4180451,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
URINAL (DISP),4180452,CDM,270,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
URI-METER,4180453,CDM,270,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
URINARY LEG BAG,4180454,CDM,270,RC,,,outpatient,,,8.5,5.53,,5.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.28,8.08,
URINE COLLECTOR PEDIATRIC,4180455,CDM,270,RC,,,outpatient,,,38.22,24.84,,25.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.58,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.49,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.23,36.31,
OSTOMY BAGS 3 PK,4180456,CDM,270,RC,,,outpatient,,,12.6,8.19,,8.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.37,11.97,
URINARY LEG BAG EXT TUBE,4180459,CDM,270,RC,,,outpatient,,,11.4,7.41,,7.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.19,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.05,10.83,
VAGINAL PACK,4180468,CDM,270,RC,,,outpatient,,,29.12,18.93,,19.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.8,27.66,
VASELINE GAUZE 3 X 9,4180470,CDM,270,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
YANKAUER SUCTION,4180500,CDM,270,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
VEST RESTRAINT SMALL,4180501,CDM,270,RC,,,outpatient,,,25.2,16.38,,16.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.94,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.75,23.94,
VEST RESTRAINT MED.,4180502,CDM,270,RC,,,outpatient,,,12.54,8.15,,8.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.29,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.41,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.91,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.36,11.91,
VEST RESTRAINT LARGE,4180503,CDM,270,RC,,,outpatient,,,25.2,16.38,,16.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.94,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.75,23.94,
ENDO TUBE,4180504,CDM,270,RC,,,outpatient,,,40.5,26.33,,27.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.84,38.48,
DRESSING 2x2 CALCIUM ALGINATE,4180900,CDM,272,RC,,,outpatient,,,144,93.6,,96.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,129.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,115.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,108,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,136.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,122.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.55,136.8,
DRESSING 3x3 HYDROCELLULAR FOAM,4180920,CDM,272,RC,,,outpatient,,,110,71.5,,73.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,99,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.45,104.5,
ANKLE BRACE 10,4181001,CDM,270,RC,,,outpatient,,,49.8,32.37,,33.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.33,47.31,
ANKLE BRACE DEPUY 3760-12,4181002,CDM,270,RC,,,outpatient,,,49.8,32.37,,33.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.33,47.31,
ANKLE BRACE 9,4181003,CDM,270,RC,,,outpatient,,,49.8,32.37,,33.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.33,47.31,
ARM IMMOBILIZER DEPUY 3516-,4181006,CDM,270,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
ARM IMMOBILIZER DEPUY 3516-,4181007,CDM,270,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
ARM SLING PEDIATRIC SMALL,4181011,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
BACK BRACE ASPEN QUICKDRAW,4181012,CDM,270,RC,,,outpatient,,,194.76,126.59,,130.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,54.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,175.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,155.81,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,146.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,185.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,165.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,116.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,116.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.14,185.02,
CAST SHOE,4181030,CDM,270,RC,,,outpatient,,,21.6,14.04,,14.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.78,20.52,
CERVICAL COLLAR DEPUY 3009-,4181035,CDM,270,RC,,,outpatient,,,60.6,39.39,,40.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.97,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.22,57.57,
CLAVICLE SPLINT MCLEOD 735--,4181036,CDM,270,RC,,,outpatient,,,34.8,22.62,,23.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.32,33.06,
CLAVICLE SPLINT MCLEOD 735-,4181037,CDM,270,RC,,,outpatient,,,34.8,22.62,,23.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.32,33.06,
CLAVICLE SPLINT MCLEOD 735-,4181038,CDM,270,RC,,,outpatient,,,34.8,22.62,,23.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.32,33.06,
FINGER SPLINT 4120-22,4181074,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
SHOULDER IMMOBILIZER 763-1,4181165,CDM,270,RC,,,outpatient,,,29.4,19.11,,19.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.87,27.93,
TIBIA - FIBULA IMMOBILIZER,4181170,CDM,270,RC,,,outpatient,,,93,60.45,,62.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,83.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,74.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.9,88.35,
TIBIA - FIBULA IMMOBILIZER PE,4181171,CDM,270,RC,,,outpatient,,,143.4,93.21,,96.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,129.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,114.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,107.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,136.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,121.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,86.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.39,136.23,
TIBIA - FIBULA IMMOBILIZER PE,4181172,CDM,270,RC,,,outpatient,,,143.4,93.21,,96.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,129.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,114.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,107.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,136.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,121.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,86.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.39,136.23,
TIBIA - FIBULA IMMOBILIZER PE,4181173,CDM,270,RC,,,outpatient,,,143.4,93.21,,96.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,129.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,114.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,107.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,136.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,121.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,86.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.39,136.23,
TRACTION ANKLET 3762-12,4181174,CDM,270,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
TRACTION ANKLET 3762-14,4181175,CDM,270,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
TRACTION BOOTS BUNNYLINE,4181176,CDM,270,RC,,,outpatient,,,26.4,17.16,,17.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.07,25.08,
TRACTION KITS 3871-02,4181177,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
TRACTION KITS 3871-03,4181178,CDM,270,RC,,,outpatient,,,14.4,9.36,,9.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.85,13.68,
TRACTION SPLINT 2753-10,4181179,CDM,270,RC,,,outpatient,,,49.8,32.37,,33.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.33,47.31,
TRACTION SPLINT 2753-11,4181180,CDM,270,RC,,,outpatient,,,49.8,32.37,,33.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.33,47.31,
TRACTION SPLINT 2753-12,4181181,CDM,270,RC,,,outpatient,,,49.8,32.37,,33.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.33,47.31,
TRACTION SPLINT 2753-13,4181182,CDM,270,RC,,,outpatient,,,49.8,32.37,,33.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.82,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.33,47.31,
UNIVERSAL RIB BELT 722-01,4181200,CDM,270,RC,,,outpatient,,,29.4,19.11,,19.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.87,27.93,
UNIVERSAL RIB BELT 2721-06,4181201,CDM,270,RC,,,outpatient,,,29.4,19.11,,19.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.87,27.93,
UNIVERSAL RIB BELT 3215-01,4181202,CDM,270,RC,,,outpatient,,,29.4,19.11,,19.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.87,27.93,
WAIST RESTRAINT 3804-10,4181210,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
WAIST RESTRAINT 3804-12,4181211,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
WAIST RESTRAINT 3804-14,4181212,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
WALKING HEEL DUVAL 992-12,4181213,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
WALKING HEEL DUVAL 993,4181214,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
WALKING HEEL DUVAL 993-12,4181215,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
WALKING HEEL DUVAL 994-12,4181216,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
WRIST SPLINT DEPUY,4181220,CDM,270,RC,,,outpatient,,,49.2,31.98,,32.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.74,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.17,46.74,
WRIST SPLINT DEPUY 3815-20,4181221,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
WRIST SPLINT DEPUY 3815-24,4181222,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
WRIST SPLINT R. SMALL,4181223,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
WRIST SPLINT DEPUY 3832-20,4181224,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
ARM SLING XLARGE,4181225,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
WRIST SPLINT EXTRA LARGE,4181226,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
WRIST SPLINT LARGE,4181227,CDM,270,RC,,,outpatient,,,147.42,95.82,,98.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,41.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,132.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,41.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,117.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,110.57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,40.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,125.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,88.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.46,140.05,
WRIST SPLINT ZIMMER 759-01,4181228,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
WRIST SPLINT ZIMMER 759-02,4181229,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
WRIST SPLINT ZIMMER 759-03,4181230,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
ANKLE CAST,4181231,CDM,270,RC,,,outpatient,,,41.4,26.91,,27.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.08,39.33,
ARM CAST INCLUDING ELBOW,4181232,CDM,270,RC,,,outpatient,,,81,52.65,,54.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.68,76.95,
ARM CAST TO ELBOW,4181233,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
ARM SPLINT TO ELBOW,4181234,CDM,270,RC,,,outpatient,,,52.8,34.32,,35.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.13,50.16,
HALF ARM CAST,4181235,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
HAND CAST,4181236,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
KNEE CAST,4181237,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
FULL LEG ABOVE KNEE,4181238,CDM,270,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
SHORT LEG CAST,4181239,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
WALKING IRON WITH TREAD,4181250,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
WALKING HEEL,4181251,CDM,270,RC,,,outpatient,,,26.4,17.16,,17.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.07,25.08,
ARM SPLINT W/ELBOW,4181260,CDM,270,RC,,,outpatient,,,22.8,14.82,,15.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.1,21.66,
ARM SPLINT - LONG,4181261,CDM,270,RC,,,outpatient,,,48.6,31.59,,32.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.01,46.17,
BANJO SPLINT FULL SET,4181262,CDM,270,RC,,,outpatient,,,129.6,84.24,,86.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,116.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,103.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,77.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.69,123.12,
ELASTIC WRIST SPLINT,4181265,CDM,270,RC,,,outpatient,,,39.6,25.74,,26.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,37.62,
FINGER SPLINT,4181266,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
FOREARM SPLINT,4181267,CDM,270,RC,,,outpatient,,,42.5,27.63,,28.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.38,40.38,
LATERAL ARM SPLINT,4181268,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
METACARPEL SPLINT,4181269,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
POSTERIOR ADJ ELBOW SPLINT,4181270,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
POSTERIOR NON ADJ ELBOW SPL,4181271,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
POSTERIOR LONG LEG SPLINT,4181272,CDM,270,RC,,,outpatient,,,72.6,47.19,,48.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,65.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,58.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.44,68.97,
POSTERIOR KNEE LEG SPLINT,4181273,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
POSTERIOR SHORT LEG SPLINT,4181274,CDM,270,RC,,,outpatient,,,68.4,44.46,,45.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,41.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.31,64.98,
WRIST STRAP THUMB OR FINGER,4181275,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
WRIST SPLINT LG RT,4181811,CDM,270,RC,,,outpatient,,,5.4,3.51,,3.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.45,5.13,
WRIST SPLINT MED LEFT,4181812,CDM,270,RC,,,outpatient,,,67.2,43.68,,45.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,60.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,50.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.99,63.84,
WRIST SPLINT MED RT,4181813,CDM,270,RC,,,outpatient,,,5.4,3.51,,3.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.45,5.13,
WRIST SPLINT  SM LEFT,4181814,CDM,270,RC,,,outpatient,,,5.4,3.51,,3.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.45,5.13,
WRIST SPLINT DEPUY 383224 SM RT,4181815,CDM,270,RC,,,outpatient,,,5.4,3.51,,3.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.45,5.13,
CLEARCATH 18,4182001,CDM,270,RC,,,outpatient,,,9.5,6.18,,6.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.54,9.03,
CLEARCATH 20,4182002,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
CLEARCATH 22,4182003,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
BLOOD EXCHANGE TRANSFUSION,4182022,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
PRIMARY SET,4182030,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
BLOOD INLINE ADAPTER WITH F,4182032,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
SECONDARY SET,4182033,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
BLOOD TRANSFUSION SET,4182034,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
NITRO SET,4182035,CDM,270,RC,,,outpatient,,,8.1,5.27,,5.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.29,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.08,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.27,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.17,7.7,
MANNITOL SET,4182036,CDM,270,RC,,,outpatient,,,28.67,18.64,,19.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.67,27.24,
CATHETER INTRAMEDICUT 14 G,4182040,CDM,270,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
CATHETER INTRAMEDICUT 14 G,4182041,CDM,270,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
CATHETER INTRAMEDICUT 16 G,4182042,CDM,270,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
CATHETER INTRAMEDICUT 16 G,4182043,CDM,270,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
CATHETER INTRAMEDICUT 18 G,4182044,CDM,270,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
CHOLANGIORAM CATHETER,4182045,CDM,270,RC,,,outpatient,,,45,29.25,,30.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,40.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.05,42.75,
CUTDOWN CATHETER 16,4182047,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
CUTDOWN CATHETER 18,4182048,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
CUTDOWN CATHETER 22,4182049,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
INTRACATH 16 GA 12 INCH,4182050,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
INTRACATH 16 GA 8 INCH,4182051,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
VENIKIT W/BUTTERFLY 19,4182054,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
VENOUS PRESSURE MONITOR,4182055,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
5.5x12 cm ADHESIVE,4182058,CDM,270,RC,,,outpatient,,,37.89,24.63,,25.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.31,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.14,36,
12x12 cm ADHESIVE,4182059,CDM,270,RC,,,outpatient,,,23.26,15.12,,15.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.93,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.61,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.23,22.1,
DRUM CARTRIDGE CATHETER,4182060,CDM,270,RC,,,outpatient,,,22.8,14.82,,15.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.1,21.66,
FILTER BLOOD TRANSFUSION TRA,4182080,CDM,270,RC,,,outpatient,,,16.8,10.92,,11.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.5,15.96,
INPERSOL CATHETER,4182110,CDM,270,RC,,,outpatient,,,26.4,17.16,,17.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.07,25.08,
I.V. PUMP SET VENTED,4182111,CDM,270,RC,,,outpatient,,,17.5,11.38,,11.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,16.63,
IV CONTROL DIAL A FLO,4182113,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
SOLUSET W/CAIR CLAMP,4182210,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
STOPCOCK 4 WAY COLOR CODED,4182212,CDM,270,RC,,,outpatient,,,21.6,14.04,,14.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.78,20.52,
SUBSUBCLAVIAN JUGULAR CATHE,4182213,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
VENIKIT W/18 G ABBOCATH,4182240,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
VENIKIT W/BUTTERFLY 21,4182241,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
VENOCATH 16,4182243,CDM,270,RC,,,outpatient,,,14.4,9.36,,9.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.85,13.68,
VENOCATH 18,4182244,CDM,270,RC,,,outpatient,,,14.4,9.36,,9.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.24,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.85,13.68,
VENOSET MICRODRIP W/FILTER,4182246,CDM,270,RC,,,outpatient,,,24.6,15.99,,16.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.91,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.59,23.37,
VENOSET PRIMARY,4182247,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
VENOSET PRIMARY W/FILTER,4182248,CDM,270,RC,,,outpatient,,,74.62,48.5,,50,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,59.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.97,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.89,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.98,70.89,
VENOSET SECONDARY,4182249,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
VENOUS PRESSURE RTRAY,4182251,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
VENIKIT WITH ABBOCATH 20,4182252,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
VENIKIT WITH ABBOCATH 22,4182253,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
CLY-Q-SET,4182254,CDM,270,RC,,,outpatient,,,32.7,21.26,,21.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.43,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.53,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.75,31.07,
Y TYPE CONNECTION SET,4182255,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
TAUT CHOLANGIOGRAM CATHETER,4182258,CDM,270,RC,,,outpatient,,,70.5,45.83,,47.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,63.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,56.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,52.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,59.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.87,66.98,
MEPILEX BORDER SACRUM,4182259,CDM,270,RC,,,outpatient,,,6.3,4.1,,4.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.67,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.73,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.69,5.99,
RHINO ROCKET,4182261,CDM,270,RC,,,outpatient,,,11.7,7.61,,7.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.53,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.13,11.12,
PUDENDAL ANESTHESIA KIT,4183001,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
DEELEE SUCTION CATH.,4183002,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
FETAL BLOOD SAMPLING TRAY,4183003,CDM,270,RC,,,outpatient,,,41.4,26.91,,27.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.08,39.33,
PERINEAL WASH KIT,4183004,CDM,270,RC,,,outpatient,,,21.6,14.04,,14.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.78,20.52,
NU-BORN BABY BATH SET,4183006,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
THERMOMETER KIT,4183008,CDM,270,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
DELIVERY ROOM PACK,4183009,CDM,270,RC,,,outpatient,,,55.8,36.27,,37.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.94,53.01,
EPIDURAL ANESTHESIA TRAY,4183012,CDM,270,RC,,,outpatient,,,41.4,26.91,,27.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.08,39.33,
FEMALE CATH. KIT,4183014,CDM,270,RC,,,outpatient,,,5,3.25,,3.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.34,4.75,
E.O.A. KITS,4183015,CDM,270,RC,,,outpatient,,,61.8,40.17,,41.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.54,58.71,
E-Z PREP TRAY,4183016,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
THERMOMETER KITS ORAL,4183017,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
CAST COVER FULL LEG SM.,4183018,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
CAST COVER FULL LEG REG.,4183019,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
CAST COVER HALF ARM SM.,4183020,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
CAST COVER HALF ARM REG.,4183021,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
OP-SITE DRESSING 4x5,4183023,CDM,270,RC,,,outpatient,,,1.5,0.98,,1.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.4,1.43,
LAY LOOPS,4183024,CDM,270,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
SHUR-CLENS W/SPONGE,4183025,CDM,270,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
BLOOD PUMP SET,4183026,CDM,270,RC,,,outpatient,,,36.5,23.73,,24.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.77,34.68,
FOAM COLLAR 3000-16,4183029,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
PUMP SET NUTRI,4183032,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
FLOTATION MATTRESS,4183033,CDM,270,RC,,,outpatient,,,130.8,85.02,,87.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,98.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.02,124.26,
C SECTION PACK,4183034,CDM,270,RC,,,outpatient,,,196.2,127.53,,131.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,54.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,143.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,176.58,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,156.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,147.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,186.39,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,166.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,117.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.52,186.39,
LAPARASCOPE PACK,4183035,CDM,270,RC,,,outpatient,,,61.8,40.17,,41.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.71,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.54,58.71,
UNDERPADS LARGE,4183036,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
CATHETER IRRIGATION SET,4183037,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
BREAST PUMP,4183038,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
SPECIPAN,4183039,CDM,270,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
KITO-DIASTIX,4183040,CDM,270,RC,,,outpatient,,,42.9,27.89,,28.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.61,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.47,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.48,40.76,
ENSURE CAN,4183042,CDM,250,RC,,,outpatient,,,125,81.25,,83.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,112.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,34.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,100,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,93.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,35.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,33.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,34.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,106.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.46,118.75,
CATHETER FOLEY 5CC 24 FR,4183046,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
FOLEY CATH 30 CC 24 FR 2 WA,4183047,CDM,270,RC,,,outpatient,,,39.6,25.74,,26.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,37.62,
NOVA PUMP SET-UP,4183048,CDM,270,RC,,,outpatient,,,88.2,57.33,,59.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.79,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.61,83.79,
CATHETER 3W 30CC 26FR,4183050,CDM,270,RC,,,outpatient,,,22.2,14.43,,14.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.87,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.94,21.09,
UNNA BOOT 3,4183052,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
UNNA BOOT 4,4183053,CDM,270,RC,,,outpatient,,,6.32,4.11,,4.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.06,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.74,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.69,6,
CAST COVER HALF LEG. SM.,4183055,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
CAST COVER HALF LEG REG.,4183056,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
CAST COVER FULL ARM SM.,4183057,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
CAST COVER FULL ARM REG.,4183058,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
INCONTIENCE COLLECTOR,4183060,CDM,270,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
VASELINE,4183061,CDM,270,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
KENITIC BED-RENTAL,4183067,CDM,270,RC,,,outpatient,,,255.6,166.14,,171.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,71.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,186.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,230.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,71.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,204.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,191.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,72.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,68.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,242.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,69.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,217.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,153.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,153.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.42,242.82,
K-PAD LEG,4183068,CDM,270,RC,,,outpatient,,,49.2,31.98,,32.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.74,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.82,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.17,46.74,
K-PAD ARM,4183069,CDM,270,RC,,,outpatient,,,31.8,20.67,,21.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.51,30.21,
SURGICLIPS M11,4183070,CDM,270,RC,,,outpatient,,,115.2,74.88,,77.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,32.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,103.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,92.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,86.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,97.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,69.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.84,109.44,
STAPLES GIA-50P,4183071,CDM,270,RC,,,outpatient,,,128.4,83.46,,86.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,115.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,35.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,102.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,96.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,109.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,77.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.37,121.98,
STAPLES 90P-4.8,4183072,CDM,270,RC,,,outpatient,,,121.2,78.78,,81.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,109.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,103.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.45,115.14,
STAPLES 55P-4.8,4183073,CDM,270,RC,,,outpatient,,,121.2,78.78,,81.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,109.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,103.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.45,115.14,
CATHETER FOLEY 5CC 28FR KIT,4183074,CDM,270,RC,,,outpatient,,,39.6,25.74,,26.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,37.62,
TEMP. PACING LEADS,4183077,CDM,270,RC,,,outpatient,,,182.4,118.56,,122.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,164.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,145.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,136.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.04,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.83,173.28,
TEMP. PACE MAKER,4183078,CDM,270,RC,,,outpatient,,,130.8,85.02,,87.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,98.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.02,124.26,
DEFIBILATOR,4183081,CDM,270,RC,,,outpatient,,,88.2,57.33,,59.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.38,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.79,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.61,83.79,
SKIN CLOSURE OP SITE,4183082,CDM,270,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
SPLINT ORTHO FELT - SM.,4183085,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
SPLINT ORTHO FELT - MED.,4183086,CDM,270,RC,,,outpatient,,,29.4,19.11,,19.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.87,27.93,
SPLINT ORTHO FELT - LEG.,4183087,CDM,270,RC,,,outpatient,,,29.4,19.11,,19.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.87,27.93,
POSTERIOR SPLINT,4183088,CDM,270,RC,,,outpatient,,,71.4,46.41,,47.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,53.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,42.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.99,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.11,67.83,
KNEE IMMORILIZER,4183089,CDM,270,RC,,,outpatient,,,154.8,100.62,,103.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,139.32,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,123.84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,116.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.06,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,131.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,92.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,92.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.44,147.06,
KNEE BRACE,4183090,CDM,270,RC,,,outpatient,,,78.6,51.09,,52.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,70.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,62.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,58.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,66.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,47.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.01,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.04,74.67,
KNEE BRACE-HINGED,4183091,CDM,270,RC,,,outpatient,,,164.4,106.86,,110.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,147.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,131.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,44.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,139.74,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,98.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.01,156.18,
FOOT LIFT,4183092,CDM,270,RC,,,outpatient,,,42,27.3,,28.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.24,39.9,
BRIEFS MEDIUM,4183096,CDM,270,RC,T4522,HCPCS,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
SARATOGA SUMP DRAIN,4183098,CDM,270,RC,,,outpatient,,,29.4,19.11,,19.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.23,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.87,27.93,
DISP. PILLOWS,4183100,CDM,270,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OVERDOOR TRACTION KIT,4183101,CDM,270,RC,,,outpatient,,,67.2,43.68,,45.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,60.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,50.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.84,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.12,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.99,63.84,
POSEY BLOCK FOOT LIFT,4183102,CDM,270,RC,,,outpatient,,,37.2,24.18,,24.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.96,35.34,
POSTOP ELECTRODES,4183104,CDM,270,RC,,,outpatient,,,31.2,20.28,,20.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.35,29.64,
INFUSION TRAY CYCFY8035,4183105,CDM,270,RC,,,outpatient,,,43.2,28.08,,28.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.88,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.72,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.56,41.04,
INFUSION TRAY CUSSY7035,4183106,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
INFUSION TRAY CUSSY8035,4183107,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
INFUSION TRAY CUSSN7035,4183108,CDM,270,RC,,,outpatient,,,36.6,23.79,,24.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.8,34.77,
INFUSION TRAY CVSSN8035,4183109,CDM,270,RC,,,outpatient,,,36.6,23.79,,24.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.8,34.77,
CHECK FLO ADAPTER CCFM-1 30,4183110,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
PRESSURE TRAY CPMSY301A,4183112,CDM,270,RC,,,outpatient,,,58.8,38.22,,39.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.74,55.86,
PRESSURE TRAY CPMSY401JFA,4183113,CDM,270,RC,,,outpatient,,,58.8,38.22,,39.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.74,55.86,
PRESSURE TRAY CPMSY301J,4183114,CDM,270,RC,,,outpatient,,,58.8,38.22,,39.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.74,55.86,
PRESSURE TRAY CPMSY401J,4183115,CDM,270,RC,,,outpatient,,,58.8,38.22,,39.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.74,55.86,
PRESSURE TRAY CPMSY501J,4183116,CDM,270,RC,,,outpatient,,,58.8,38.22,,39.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.74,55.86,
PRESSURE TRAY CPMSY631J,4183117,CDM,270,RC,,,outpatient,,,58.8,38.22,,39.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.92,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.74,55.86,
JACKSON PRATT SUCTION RESER,4183118,CDM,270,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
JACKSON PRATT SUCTION DRAIN,4183119,CDM,270,RC,,,outpatient,,,37.2,24.18,,24.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.96,35.34,
JACKSON PRATT SUC. DRAIN RO,4183120,CDM,270,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
JACKSON PRATT CONNECTORS,4183121,CDM,270,RC,,,outpatient,,,25.8,16.77,,17.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.51,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.91,24.51,
MINI PUMP SET,4183122,CDM,270,RC,,,outpatient,,,22.8,14.82,,15.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.1,21.66,
MICROBONE,4183123,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
UMBILICAL CATHETER PEDIATRIC 5.0 FR,4183125,CDM,270,RC,,,outpatient,,,23.4,15.21,,15.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.26,22.23,
UMBILICAL CATHETER PEDIATRIC 8FR,4183126,CDM,270,RC,,,outpatient,,,23.4,15.21,,15.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.26,22.23,
UMBILICAL CATHETER PED 3.5 FR,4183127,CDM,270,RC,,,outpatient,,,26.4,17.16,,17.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.07,25.08,
STOMAHESIVE 8X8,4183128,CDM,270,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
OSTOMY BAG #1085,4183129,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
VIVONEX 6 PACK,4183131,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
FOLEY CATH 20FR 5CC-2 WAY,4183132,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
CLEARCATH 24,4183133,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
SUSTACAL,4183134,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
SUSTAGEN,4183135,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
ORTHOSIS-ANKLE FOOT LEG,4183137,CDM,270,RC,,,outpatient,,,61.2,39.78,,41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.38,58.14,
SUCTION CATH 12 FR. W/AIRPO,4183138,CDM,270,RC,,,outpatient,,,8.4,5.46,,5.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.25,7.98,
BURN PACK,4183139,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
POST-OP ELECTRODES (TENS),4183140,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
IRRIGATION SET PISTON,4183141,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
NTG PUMP SET,4183142,CDM,270,RC,,,outpatient,,,97,63.05,,64.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,87.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,77.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,72.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,92.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,82.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.97,92.15,
KOALA MOUTHWASH,4183145,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
VACURETTE,4183146,CDM,270,RC,,,outpatient,,,15.6,10.14,,10.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.18,14.82,
SUTURE SET,4183150,CDM,270,RC,,,outpatient,,,122,79.3,,81.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,34.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,109.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,97.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,91.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,103.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.66,115.9,
SUCTION CATHETER,4183151,CDM,270,RC,,,outpatient,,,54.6,35.49,,36.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.87,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.41,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.62,51.87,
TRAUMACAL,4183152,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
ISOCAL,4183153,CDM,270,RC,,,outpatient,,,9,5.85,,6.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.41,8.55,
NASAL AIRWAYS,4183154,CDM,270,RC,,,outpatient,,,42.6,27.69,,28.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.47,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.21,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.93,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.4,40.47,
EXAM KIT RAPE,4183155,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
JACKSON PRATT T-TUBE,4183156,CDM,270,RC,,,outpatient,,,30.6,19.89,,20.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.07,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.19,29.07,
"KNEE IMMOB. SMALL, MED.LAR",4183159,CDM,270,RC,,,outpatient,,,48,31.2,,32.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.85,45.6,
VASELINE,4183160,CDM,270,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
GAUZE BANDAGE 3,4183162,CDM,270,RC,,,outpatient,,,1.5,0.98,,1.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.4,1.43,
T.E.D.KNEE HIGH HOSE SMALL,4183164,CDM,270,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
T.E.D.KNEE HIGH HOSE MEDIU,4183165,CDM,270,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
"T.E.D.KNEE HIGH HOSE LARGE, XL & XXL",4183166,CDM,270,RC,,,outpatient,,,29.5,19.18,,19.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.9,28.03,
SURGIPORT TROCAR 5MM/7MM,4183167,CDM,270,RC,,,outpatient,,,151.2,98.28,,101.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,136.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,120.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,113.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,42.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,143.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,128.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,90.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.48,143.64,
SURGIPORT TROCAR 10MM,4183168,CDM,270,RC,,,outpatient,,,183,118.95,,122.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,164.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,146.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,137.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.99,173.85,
PI-55 INT. STAPLES MED,4183170,CDM,270,RC,,,outpatient,,,110.4,71.76,,73.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,99.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,88.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,66.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.55,104.88,
PI-90 INT. STAPLES LG.,4183171,CDM,270,RC,,,outpatient,,,114,74.1,,76.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,102.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,91.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,85.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,96.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.52,108.3,
ILA-52 INT. INT. STAPLES,4183172,CDM,270,RC,,,outpatient,,,125.1,81.32,,83.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,112.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,34.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,100.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,93.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,35.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,33.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,35.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,34.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,106.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,75.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.49,118.85,
PI-55 INT. STAPLES LG.,4183173,CDM,270,RC,,,outpatient,,,110.4,71.76,,73.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,99.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,88.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,66.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.55,104.88,
MEASURING CONTAINER,4183174,CDM,270,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
LDS 15W SUTURE,4183175,CDM,270,RC,,,outpatient,,,348,226.2,,233.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,97.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,97.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,254.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,313.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,96.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,278.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,261,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,98.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,93.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,97.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,330.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,95.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,295.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,208.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,208.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.16,330.6,
FOLEY CATH 28 FR,4183179,CDM,270,RC,,,outpatient,,,39.6,25.74,,26.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,37.62,
FOLEY CATH 30 FR 30 CC 2 WAY,4183180,CDM,270,RC,,,outpatient,,,39.6,25.74,,26.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,37.62,
FOLEY CATH 16 FR 30CC 3 WAY,4183181,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
FOLEY CATH 24 FR 5CC 3 WAY,4183182,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
FOLEY CATH 26 FR 30CC 3 WAY,4183183,CDM,270,RC,,,outpatient,,,39.6,25.74,,26.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,37.62,
FOLEY CATH 18 FR 30CC 3 WAY,4183184,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
FOLEY CATH 18 FR 75CC 3 WAY,4183185,CDM,270,RC,,,outpatient,,,40.2,26.13,,26.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.76,38.19,
BERKLEY COLLECTIOM SET,4183187,CDM,270,RC,,,outpatient,,,31.2,20.28,,20.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.35,29.64,
CV CATHERIZATION SET,4183188,CDM,270,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
PNEUMATIC SAW,4183189,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
EEA STAPLES #28,4183190,CDM,270,RC,,,outpatient,,,543,352.95,,363.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,152.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,152.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,396.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,488.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,151.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,434.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,407.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,153.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,145.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,152.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,515.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,148.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,461.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,325.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,325.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,145.36,515.85,
EEA STAPLES #31,4183191,CDM,270,RC,,,outpatient,,,543,352.95,,363.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,152.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,152.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,396.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,488.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,151.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,434.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,407.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,153.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,145.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,152.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,515.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,148.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,461.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,325.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,325.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,145.36,515.85,
QUICK PACE EXT. CASSETTE,4183192,CDM,270,RC,,,outpatient,,,65.4,42.51,,43.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.51,62.13,
RADIAL CATHETER KIT,4183193,CDM,270,RC,,,outpatient,,,23.4,15.21,,15.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.26,22.23,
STERI DRAPE,4183194,CDM,270,RC,,,outpatient,,,37.2,24.18,,24.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.96,35.34,
BARICON,4183198,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
BE TIPS,4183200,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
Y-TUBING,4183203,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
BELONGING BAGS,4183205,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
ESOPHAGEAL STETHOSCOPE,4183206,CDM,270,RC,,,outpatient,,,32.4,21.06,,21.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,30.78,
URETHRAL CATHETER 8 FRENCH,4183207,CDM,270,RC,,,outpatient,,,9.6,6.24,,6.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.57,9.12,
SURGICAL CLIPPERS 3M,4183208,CDM,270,RC,,,outpatient,,,35.5,23.08,,23.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.5,33.73,
CATHETER STRAP,4183211,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
LAP SHEET,4183212,CDM,270,RC,,,outpatient,,,98.28,63.88,,65.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.62,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.71,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.54,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.31,93.37,
FILM COPY,4183213,CDM,270,RC,,,outpatient,,,9.9,6.44,,6.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.91,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.43,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.41,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.77,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.65,9.41,
GASTROSTOMY TUBE 18FR&20FR,4183214,CDM,270,RC,,,outpatient,,,63.6,41.34,,42.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.24,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.06,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.03,60.42,
GASTROSTOMY TUBE 14FR & 16FR,4183215,CDM,270,RC,,,outpatient,,,57.6,37.44,,38.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.96,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.13,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.42,54.72,
AP LIGATING CLIPS,4183219,CDM,270,RC,,,outpatient,,,16.8,10.92,,11.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.5,15.96,
AP300 LIGATING CLIPS,4183220,CDM,270,RC,,,outpatient,,,17.4,11.31,,11.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.66,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.92,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.79,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.87,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.66,16.53,
AP400,4183221,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
MAXI VESSEL LOOP RED,4183225,CDM,270,RC,,,outpatient,,,15.6,10.14,,10.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.18,14.82,
MAXI VESSELL LOOP BLUE,4183226,CDM,270,RC,,,outpatient,,,15.6,10.14,,10.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.18,14.82,
ADULT DIAPERS (SINGLE),4183230,CDM,270,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
CVC-KIT WITH LUMEN,4183232,CDM,270,RC,,,outpatient,,,51.6,33.54,,34.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.81,49.02,
SURGIGRIP 5mm,4183233,CDM,270,RC,,,outpatient,,,37.2,24.18,,24.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.96,35.34,
SURGIGRIP 10mm,4183234,CDM,270,RC,,,outpatient,,,37.2,24.18,,24.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.96,35.34,
CONVERTOR 5.5mm,4183235,CDM,270,RC,,,outpatient,,,37.2,24.18,,24.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.96,35.34,
CONVERTOR 3.5mm,4183236,CDM,270,RC,,,outpatient,,,37.2,24.18,,24.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.48,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.62,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.96,35.34,
ENDOCLIP MED/LARGE,4183237,CDM,270,RC,,,outpatient,,,324.6,210.99,,217.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,90.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,90.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,236.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,292.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,90.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,259.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,243.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,91.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,86.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,90.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,308.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,88.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,275.91,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,194.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,194.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.9,308.37,
CAPNOMETER,4183238,CDM,270,RC,,,outpatient,,,51.6,33.54,,34.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.86,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.81,49.02,
ENTERIC TUBE #16,4183242,CDM,270,RC,,,outpatient,,,52.2,33.93,,34.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.97,49.59,
0 PROLENE 8148H,4183243,CDM,270,RC,,,outpatient,,,16.8,10.92,,11.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.5,15.96,
3-0 SURGILON 1958-42,4183244,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
GASTROSTOMY TUBE 16fr,4183245,CDM,270,RC,,,outpatient,,,50.4,32.76,,33.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.49,47.88,
DURA PREP TRAY,4183247,CDM,270,RC,,,outpatient,,,15.6,10.14,,10.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.82,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.26,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.18,14.82,
CHOLE LAP PACK,4183248,CDM,270,RC,,,outpatient,,,60.4,39.26,,40.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.17,57.38,
ENDO-CHOLANGIOCATHER,4183253,CDM,270,RC,,,outpatient,,,237.6,154.44,,159.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,66.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,213.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,66.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,190.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,178.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,67.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,63.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,225.72,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,201.96,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.61,225.72,
TROCHAR 10MM,4183257,CDM,270,RC,,,outpatient,,,174,113.1,,116.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,48.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,156.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,48.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,139.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,130.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,46.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,165.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,47.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,147.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.58,165.3,
TROCHAR #12,4183258,CDM,270,RC,,,outpatient,,,191.4,124.41,,128.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,53.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,139.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,172.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,53.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,153.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,143.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,54.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,51.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,52.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,162.69,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,114.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.24,181.83,
CONVERTOR 10.5 MM,4183259,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
ENDOGAUGE INST,4183260,CDM,270,RC,,,outpatient,,,36.6,23.79,,24.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.11,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.8,34.77,
SURGIGRIPS 12MM,4183261,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
SAG-WIDE BLADE,4183263,CDM,270,RC,,,outpatient,,,112.2,72.93,,75.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,100.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,89.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.04,106.59,
SAG-NARROW BLADE,4183264,CDM,270,RC,,,outpatient,,,112.2,72.93,,75.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,100.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,89.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.04,106.59,
SAG-RASP BLADE,4183265,CDM,270,RC,,,outpatient,,,112.2,72.93,,75.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,100.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,89.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.04,106.59,
DISP. SHARPS CONTAINER,4183266,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
DVT LEG CUFFS/PAIR (VENODYNE),4183267,CDM,270,RC,,,outpatient,,,41.4,26.91,,27.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.59,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.08,39.33,
CHEST-TUBE SET-UP,4183268,CDM,270,RC,,,outpatient,,,22.8,14.82,,15.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.66,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.1,21.66,
"SEAL-UP 5.5 ,,",4183273,CDM,270,RC,,,outpatient,,,16.8,10.92,,11.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.5,15.96,
POOLE SUCTION,4183274,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
HERNIA STAPLE,4183275,CDM,270,RC,,,outpatient,,,121.2,78.78,,81.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,109.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,103.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.45,115.14,
CLO-TEST CT-20,4183276,CDM,300,RC,,,outpatient,,,26.4,17.16,,17.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.07,25.08,
TRANSFER GOWN,4183277,CDM,270,RC,,,outpatient,,,2,1.3,,1.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.54,1.9,
BARRIER 2pc W/FL,4183280,CDM,270,RC,,,outpatient,,,10.2,6.63,,6.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.65,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.67,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.73,9.69,
TELEMETRY POUCH,4183281,CDM,270,RC,,,outpatient,,,53.5,34.78,,35.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.32,50.83,
SURGI-BRA,4183282,CDM,270,RC,,,outpatient,,,72.6,47.19,,48.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,65.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,58.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.33,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.44,68.97,
I.V. OPSITE DRESSING,4183287,CDM,270,RC,,,outpatient,,,1,0.65,,0.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.27,0.95,
BIOPSY NEEDLE,4183290,CDM,270,RC,,,outpatient,,,42,27.3,,28.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.24,39.9,
JEJUNOSTOMY CATHETER,4183291,CDM,270,RC,,,outpatient,,,339.6,220.74,,227.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,95.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,95.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,247.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,305.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,94.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,271.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,254.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,96.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,90.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,95.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,322.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,92.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,288.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,203.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,90.91,322.62,
SILICONE FOLEY CATHETER 16 FR.,4183292,CDM,270,RC,,,outpatient,,,39.6,25.74,,26.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,37.62,
KOPANS LOCALIZER NEEDLE,4183294,CDM,270,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
KERLIX (LG.ROLL) 6 PLY,4183296,CDM,270,RC,,,outpatient,,,1.5,0.98,,1.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.4,1.43,
E.T. COMB. TUBE,4183299,CDM,270,RC,,,outpatient,,,110.4,71.76,,73.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,99.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,88.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,66.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.91,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.55,104.88,
NEHZART-DORSEY TUBING,4183300,CDM,270,RC,,,outpatient,,,61.2,39.78,,41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.14,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.02,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.38,58.14,
UNIVERSAL KNEE SUPPORT,4183301,CDM,270,RC,,,outpatient,,,40.8,26.52,,27.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.92,38.76,
SWISS GASTRIC LAVAGE,4183303,CDM,270,RC,,,outpatient,,,44.4,28.86,,29.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.96,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.74,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.89,42.18,
MORGAN LENS (EYE IRRIGATION),4183304,CDM,270,RC,,,outpatient,,,25.2,16.38,,16.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.94,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.42,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.75,23.94,
FOOT PILLOW,4183305,CDM,270,RC,,,outpatient,,,39.6,25.74,,26.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.64,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.62,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.66,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.09,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.6,37.62,
VENILOOP CONNECTOR,4183306,CDM,270,RC,,,outpatient,,,10.8,7.02,,7.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.89,10.26,
STOPCOCK/EX SHORT 20,4183307,CDM,270,RC,,,outpatient,,,21.6,14.04,,14.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.44,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.2,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.52,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.05,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.78,20.52,
CAST REPAIR,4183308,CDM,270,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
AIR SPLINT-ANKLE,4183309,CDM,270,RC,,,outpatient,,,102,66.3,,68.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,91.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,81.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.31,96.9,
CAST ARM BAND,4183310,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
STACK FINGER SPLINT,4183311,CDM,270,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
VISCERA RETAINER  FISH,4183322,CDM,270,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
ETHICON ER320 CLIP APPLIER,4183331,CDM,270,RC,,,outpatient,,,356.4,231.66,,238.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,99.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,99.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,260.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,320.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,99.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,285.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,267.3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,100.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,95.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,99.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,338.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,97.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,302.94,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,213.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.79,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.41,338.58,
ATRIUM MESH HERNIA REPAIR,4183336,CDM,270,RC,,,outpatient,,,220,143,,147.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,198,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,61.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,176,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,165,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,62.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,209,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,187,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.89,209,
PROLENE MESH PMII,4183338,CDM,270,RC,,,outpatient,,,182,118.3,,121.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,163.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,145.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,136.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,154.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.72,172.9,
WHELAN-MOSS T-TUBE,4183339,CDM,270,RC,,,outpatient,,,79,51.35,,52.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,71.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,63.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,59.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.15,75.05,
ASTT SPLIT CATH ASPC 28,4183342,CDM,270,RC,,,outpatient,,,1100,715,,737,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,308,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,294.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,308,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,803,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,990,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,306.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,880,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,825,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,311.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,294.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,308,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1045,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,300.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,935,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,308,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,294.47,1045,
RAULERSON DUO-FLOW CATH,4183343,CDM,270,RC,,,outpatient,,,141,91.65,,94.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.75,133.95,
RAULERSON INTERNAL JUGULAR CATH TRAY,4183344,CDM,270,RC,,,outpatient,,,550,357.5,,368.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,154,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,154,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,401.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,495,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,153.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,440,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,412.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,155.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,147.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,154,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,522.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,150.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,467.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,330,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,154,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,330,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,147.24,522.5,
DLC-800 KEC 8 X 11.5FR,4183345,CDM,270,RC,,,outpatient,,,220,143,,147.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,198,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,61.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,176,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,165,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,62.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,209,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,187,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.89,209,
DLC-600 KEC 6 X 11.5FR,4183346,CDM,270,RC,,,outpatient,,,220,143,,147.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,198,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,61.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,176,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,165,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,62.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,209,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,187,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.89,209,
GRAFT THIN WALL 6MM X 45CM,4183347,CDM,270,RC,,,outpatient,,,1760,1144,,1179.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,492.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,492.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1284.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1584,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,490,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1408,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1320,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,497.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,471.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,492.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1672,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,480.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1496,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1056,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,492.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1056,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,471.15,1672,
GRAFT THIN WALL 6MM X 50CM,4183348,CDM,270,RC,,,outpatient,,,1540,1001,,1031.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,431.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,412.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,431.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1124.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1386,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,428.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1232,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1155,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,435.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,412.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,431.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1463,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,420.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1309,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,924,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,431.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,924,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,412.26,1463,
GRAFT 4-7MM X 40CM,4183349,CDM,270,RC,,,outpatient,,,1320,858,,884.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,369.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,353.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,369.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,963.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1188,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,367.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1056,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,990,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,373.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,353.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,369.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1254,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,360.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1122,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,353.36,1254,
ARTERIAL EMBOLECTOMY CATHETER #4,4183350,CDM,270,RC,,,outpatient,,,176,114.4,,117.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,158.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,140.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,132,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,47.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,48.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,149.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.12,167.2,
ARTERIAL EMBOLECTOMY CATHETER #5,4183351,CDM,270,RC,,,outpatient,,,176,114.4,,117.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,158.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,140.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,132,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,47.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,48.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,149.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.12,167.2,
FOGARTY IRRIGATION CATHETER #4,4183352,CDM,270,RC,,,outpatient,,,83,53.95,,55.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,74.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.22,78.85,
CATHETER BILIARY 5 FR,4183353,CDM,270,RC,,,outpatient,,,209,135.85,,140.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,58.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,188.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,58.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,167.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,156.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,59.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,55.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,198.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,57.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,177.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.95,198.55,
CAROTID PATCH 8 X 75MM,4183354,CDM,270,RC,,,outpatient,,,347,225.55,,232.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,97.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,92.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,97.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,253.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,312.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,96.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,277.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,260.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,98.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,92.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,97.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,329.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,94.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,294.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,92.89,329.65,
SPRINGWIRE GUIDE .035,4183356,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
FOGARTY IRRIGATION CATH #6,4183358,CDM,270,RC,,,outpatient,,,83,53.95,,55.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,74.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.22,78.85,
VICRYL KNITTED MESH,4183359,CDM,270,RC,,,outpatient,,,1078,700.7,,722.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,301.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,288.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,301.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,786.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,970.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,300.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,862.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,808.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,304.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,288.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,301.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1024.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,294.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,916.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,646.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,646.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,288.58,1024.1,
HEMO-CATH SHORT TERM 11.5 FR X 20 CM,4183360,CDM,270,RC,,,outpatient,,,330,214.5,,221.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,92.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,240.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,297,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,91.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,264,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,247.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,93.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,88.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,313.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,90.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,280.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,198,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,198,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,88.34,313.5,
4-0 VICRYL J214H,4183361,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
PMII PROLENE MESH 3 X 5,4183362,CDM,270,RC,,,outpatient,,,215,139.75,,144.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,60.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,193.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,59.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,172,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,161.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,60.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,57.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,204.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,58.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,182.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,129,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.56,204.25,
7-0 PROLENE 8702H,4183363,CDM,270,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
6-0 PROLENE 8805H,4183364,CDM,270,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
5-0 PROLENE 8720H,4183365,CDM,270,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
6-0 PROLENE 8706H,4183366,CDM,270,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
5-0 PROLENE 9702H,4183367,CDM,270,RC,,,outpatient,,,83,53.95,,55.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,74.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.22,78.85,
4-0 PROLENE 8557H,4183368,CDM,270,RC,,,outpatient,,,44,28.6,,29.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.78,41.8,
6-0 SILK 1675H,4183370,CDM,270,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
6-0 PROLENE M8726,4183371,CDM,270,RC,,,outpatient,,,132,85.8,,88.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,118.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,105.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.34,125.4,
6-0 PROLENE 8680H,4183372,CDM,270,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
DEV-O-LOOPS (MINI BLUE) 6003,4183374,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
5-0 VICRYL J421H,4183377,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
5-0 VICRYL J213H,4183378,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
5-0 MONOSOT SN1668,4183379,CDM,270,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
J109T VICRYL 4-0,4183381,CDM,270,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
J270H O-VICRYL,4183382,CDM,270,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
678H 0-SILK,4183383,CDM,270,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
8417H 2-0 SILK,4183384,CDM,270,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
VALVE & CAP RV-1000,4183387,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
SITE RITE NEEDLE GUIDE,4183389,CDM,270,RC,,,outpatient,,,44,28.6,,29.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.78,41.8,
SITE RITE PROBE COVER,4183390,CDM,270,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
PATELLA WRAP,4183391,CDM,270,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
QUICK TRACH 4.0mm,4183393,CDM,270,RC,,,outpatient,,,291,189.15,,194.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,81.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,81.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,212.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,261.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,81.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,232.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,218.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,82.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,81.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,276.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,79.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,247.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.9,276.45,
MEDIPORE 2,4183394,CDM,270,RC,,,outpatient,,,11,7.15,,7.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.94,10.45,
MEDIPORE 1,4183395,CDM,270,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
3-0 SILK SA84H,4183396,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
ETHICON TLC55,4183397,CDM,270,RC,,,outpatient,,,759,493.35,,508.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,212.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,212.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,554.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,683.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,211.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,607.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,569.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,214.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,203.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,212.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,721.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,207.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,645.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,455.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,455.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,203.18,721.05,
ETHICON TCR55,4183398,CDM,270,RC,,,outpatient,,,407,264.55,,272.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,113.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,113.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,297.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,366.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,113.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,325.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,305.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,115.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,108.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,113.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,386.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,111.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,345.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,244.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,244.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,108.95,386.65,
ETHICON TRT55,4183399,CDM,270,RC,,,outpatient,,,396,257.4,,265.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,110.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,110.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,289.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,356.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,110.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,316.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,297,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,111.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,106.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,110.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,376.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,108.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,336.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,106.01,376.2,
ETHICON TLC75,4183400,CDM,270,RC,,,outpatient,,,1128,733.2,,755.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,315.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,301.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,315.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,823.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1015.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,314.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,902.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,846,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,319,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,301.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,315.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1071.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,308.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,958.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,676.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,676.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,308.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,301.97,1071.6,
ETHICON TCR75,4183401,CDM,270,RC,,,outpatient,,,660,429,,442.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,184.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,176.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,184.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,481.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,594,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,183.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,528,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,495,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,186.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,176.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,184.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,627,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,180.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,561,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,396,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,396,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,176.68,627,
ETHICON TCT75,4183402,CDM,270,RC,,,outpatient,,,1210,786.5,,810.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,338.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,323.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,338.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,883.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1089,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,336.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,968,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,907.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,342.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,323.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,338.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1149.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,330.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1028.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,338.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,330.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,323.92,1149.5,
ETHICON TRT75,4183403,CDM,270,RC,,,outpatient,,,660,429,,442.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,184.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,176.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,184.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,481.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,594,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,183.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,528,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,495,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,186.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,176.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,184.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,627,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,180.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,561,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,396,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,396,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,176.68,627,
SKIN STAPLES PXW 35,4183404,CDM,270,RC,,,outpatient,,,44,28.6,,29.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.78,41.8,
SURGILAN PLUS HANDPIECE,4183408,CDM,270,RC,,,outpatient,,,165,107.25,,110.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,132,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.17,156.75,
DISPOSABLE CYTOLOGY BRUSH,4183411,CDM,270,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
QUICK-COMBO ELECTRODES,4183412,CDM,270,RC,,,outpatient,,,106,68.9,,71.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,95.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,84.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,79.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,90.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.38,100.7,
ARTERIAL EMBOLECTOMY CATHETER 3FR,4183415,CDM,270,RC,,,outpatient,,,407,264.55,,272.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,113.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,113.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,297.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,366.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,113.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,325.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,305.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,115.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,108.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,113.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,386.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,111.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,345.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,244.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,244.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,108.95,386.65,
ROTH POLP NET 2.5,4183417,CDM,270,RC,,,outpatient,,,165,107.25,,110.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,132,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.17,156.75,
ROTH POLP NET 3.0,4183418,CDM,270,RC,,,outpatient,,,204,132.6,,136.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,57.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,148.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,183.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,56.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,163.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,153,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,57.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,54.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,193.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,55.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,173.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.61,193.8,
OPTHALMIC KNIFE,4183419,CDM,270,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
UPPER BODY HUGGER,4183420,CDM,270,RC,,,outpatient,,,44,28.6,,29.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.78,41.8,
FULL BODY HUGGER,4183421,CDM,270,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
DEFIB PAD,4183423,CDM,270,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
PDS-0 Z352H,4183426,CDM,270,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
CODMAN VEIN STRIPS,4183427,CDM,270,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
3-0 PROLENE 8762H,4183428,CDM,270,RC,,,outpatient,,,112.84,73.35,,75.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,101.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,90.27,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.91,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.21,107.2,
3-0 PROLENE 8832H,4183429,CDM,270,RC,,,outpatient,,,19.2,12.48,,12.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.28,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.14,18.24,
COMPRESSION SLEEVES T/L MED,4183430,CDM,270,RC,,,outpatient,,,180,117,,120.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,162,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,144,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,135,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,50.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,171,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,153,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.19,171,
COMPRESSION SLEEVES T/L LARGE,4183431,CDM,270,RC,,,outpatient,,,135,87.75,,90.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,121.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,108,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,101.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,38.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,36.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.14,128.25,
BARRIER FILM,4183435,CDM,270,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
BARRIER CREAM,4183436,CDM,270,RC,,,outpatient,,,3,1.95,,2.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.8,2.85,
SKIN CLEANER,4183437,CDM,270,RC,,,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.35,19,
SPMM-149 MESH,4183439,CDM,270,RC,,,outpatient,,,550,357.5,,368.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,154,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,154,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,401.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,495,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,153.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,440,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,412.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,155.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,147.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,154,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,522.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,150.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,467.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,330,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,154,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,330,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,147.24,522.5,
I.V. HANDBOARD ADULT,4183440,CDM,270,RC,,,outpatient,,,9.5,6.18,,6.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.54,9.03,
DUAL SPIKE ADAPTER,4183441,CDM,270,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
WALKER BOOT,4183444,CDM,270,RC,,,outpatient,,,120,78,,80.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,108,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.12,114,
INCISION & DRAINAGE TRAY,4183449,CDM,270,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
PEDIATRIC OXISENSOR II,4183450,CDM,270,RC,,,outpatient,,,32,20.8,,21.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.57,30.4,
RE-NEW 11 SCISSORS TIPS,4183451,CDM,270,RC,,,outpatient,,,133,86.45,,89.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,119.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.6,126.35,
5MM TRISTAR TROCAR 355L,4183452,CDM,270,RC,,,outpatient,,,425,276.25,,284.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,310.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,382.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,118.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,340,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,318.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,120.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,113.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,403.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,361.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.77,403.75,
10/12 DILATING TROCAR 512XD,4183453,CDM,270,RC,,,outpatient,,,675,438.75,,452.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,180.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,492.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,607.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,187.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,540,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,506.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,190.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,180.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,641.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,573.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,180.7,641.25,
ADULT DIAPERS LARGE,4183454,CDM,270,RC,,,outpatient,,,2.5,1.63,,1.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.67,2.38,
CENTRAL LINE TRAY,4183460,CDM,270,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
BARD IMPLANTED PORT W/GROSHONG CATH,4183461,CDM,272,RC,,,outpatient,,,1700,1105,,1139,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,476,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,455.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,476,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1241,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1530,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,473.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1360,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1275,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,480.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,455.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,476,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1615,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,464.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1445,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1020,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,476,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1020,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,464.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,455.09,1615,
WINGED INFUSION SET,4183462,CDM,270,RC,,,outpatient,,,23.5,15.28,,15.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.29,22.33,
NEEDLE FREE VALVE,4183463,CDM,270,RC,,,outpatient,,,3.5,2.28,,2.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.94,3.33,
IV SELECT,4183464,CDM,270,RC,,,outpatient,,,4.5,2.93,,3.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.2,4.28,
TRUPATH BIOPSY,4183465,CDM,272,RC,,,outpatient,,,54,35.1,,36.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,51.3,
MULTI VAC WAND W/CABLE,4183475,CDM,270,RC,,,outpatient,,,311.25,202.31,,208.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,87.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,87.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,227.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,280.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,86.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,249,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,233.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,88.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,83.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,87.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,295.69,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,84.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,264.56,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,186.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,186.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.32,295.69,
MEDICAL DEVICE ORGANIZER,4183476,CDM,270,RC,,,outpatient,,,20.5,13.33,,13.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.49,19.48,
POLYTRAP,4183477,CDM,270,RC,,,outpatient,,,44.59,28.98,,29.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,40.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.67,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.36,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.94,42.36,
10mm DUAL MESH PLUSH,4183480,CDM,270,RC,,,outpatient,,,1300,845,,871,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,364,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,348.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,364,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,949,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1170,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,361.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1040,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,975,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,367.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,348.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,364,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1235,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,354.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1105,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,364,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,354.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,348.01,1235,
SILVASORB,4183481,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
MEPILEX SACRUM,4183484,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
SUTURE REMOVAL KIT,4183485,CDM,270,RC,,,outpatient,,,13.5,8.78,,9.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.61,12.83,
OPTIFOAM 4x4,4183488,CDM,270,RC,,,outpatient,,,12.5,8.13,,8.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.35,11.88,
OPTIFOAM SACRUM,4183489,CDM,270,RC,,,outpatient,,,21.5,13.98,,14.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.76,20.43,
SILVASORB 0.25OZ TUBE,4183490,CDM,270,RC,,,outpatient,,,9.5,6.18,,6.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.54,9.03,
PURACOL PLUS,4183491,CDM,270,RC,,,outpatient,,,22.5,14.63,,15.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.02,21.38,
ADM PACKING STRIP 1,4183497,CDM,270,RC,,,outpatient,,,20.5,13.33,,13.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.49,19.48,
NON-ADHESIVE FOAM 4x4,4183499,CDM,270,RC,,,outpatient,,,13.5,8.78,,9.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.61,12.83,
TEGADERM 5.9,4183500,CDM,270,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
SOFSORB,4183503,CDM,270,RC,,,outpatient,,,13.5,8.78,,9.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.61,12.83,
3-0 PLAIN GUT G322H,4183504,CDM,272,RC,,,outpatient,,,40.04,26.03,,26.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.04,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.03,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.03,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.72,38.04,
ARTHROSCOPY PUMP TUBING WOLF,4183505,CDM,270,RC,,,outpatient,,,108,70.2,,72.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,97.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,86.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,91.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.91,102.6,
VICRYL 423H,4183515,CDM,270,RC,,,outpatient,,,14.56,9.46,,9.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.65,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.92,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.9,13.83,
0-NEUROLON C527D,4183518,CDM,270,RC,,,outpatient,,,26.4,17.16,,17.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.76,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.39,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.07,25.08,
PLAIN 873H,4183519,CDM,270,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
PDS Z683G,4183521,CDM,270,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
EPH01 PISTOL GRIP,4183522,CDM,270,RC,,,outpatient,,,237,154.05,,158.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,213.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,65.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,189.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,177.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,67.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,63.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,225.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,201.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,142.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.44,225.15,
HPS03 CAUTERY IRR SUCTION,4183523,CDM,270,RC,,,outpatient,,,132,85.8,,88.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,118.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,105.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.34,125.4,
BONE NEEDLE 25mm EZ ID,4183525,CDM,270,RC,,,outpatient,,,428,278.2,,286.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,312.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,385.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,119.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,342.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,321,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,121.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,114.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,406.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,363.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,256.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,256.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.58,406.6,
BONE NEEDLE 15mm EZ IO,4183526,CDM,270,RC,,,outpatient,,,428,278.2,,286.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,312.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,385.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,119.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,342.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,321,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,121.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,114.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,406.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,363.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,256.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,256.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.58,406.6,
BONE NEEDLE 45mm EZ ID,4183527,CDM,270,RC,,,outpatient,,,428,278.2,,286.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,312.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,385.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,119.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,342.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,321,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,121.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,114.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,406.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,363.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,256.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,256.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.58,406.6,
PROLITE MESH 3 x 6,4183529,CDM,272,RC,,,outpatient,,,91,59.15,,60.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.36,86.45,
UNDERBUTTOCKS DRAPE,4183530,CDM,270,RC,,,outpatient,,,19.41,12.62,,13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.47,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.53,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.56,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.2,18.44,
APPLIED LAP CHOLE KIT,4183531,CDM,270,RC,,,outpatient,,,597,388.05,,399.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,167.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,159.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,167.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,435.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,537.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,166.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,477.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,447.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,168.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,159.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,167.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,567.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,163.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,507.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,358.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,358.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,159.82,567.15,
APPLIED LAPAROSOPIC SCISSORS,4183532,CDM,270,RC,,,outpatient,,,112,72.8,,75.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,100.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,89.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.98,106.4,
SURGIMESH OVAL BG MEDICAL,4183533,CDM,270,RC,,,outpatient,,,259.72,168.82,,174.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,72.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,189.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,233.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,72.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,207.78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,194.79,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,73.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,69.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,246.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,70.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,220.76,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,155.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,155.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,69.53,246.73,
WALLACH ENDOCELL SAMPLER,4183534,CDM,270,RC,,,outpatient,,,5.4,3.51,,3.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.86,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.59,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.51,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.45,5.13,
BARD CATH 16FR,4183535,CDM,270,RC,,,outpatient,,,7.39,4.8,,4.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.98,7.02,
BARD CATH 18FR,4183536,CDM,270,RC,,,outpatient,,,7.39,4.8,,4.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.98,7.02,
BARD CATH 20FR,4183537,CDM,270,RC,,,outpatient,,,7.39,4.8,,4.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.91,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.02,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.98,7.02,
COOK COUNCILL CATH 16,4183538,CDM,270,RC,,,outpatient,,,28.01,18.21,,18.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.61,
COOK COUNCILL CATH 18,4183539,CDM,270,RC,,,outpatient,,,28.01,18.21,,18.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.61,
COOK COUNCILL CATH 20,4183540,CDM,270,RC,,,outpatient,,,28.01,18.21,,18.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.21,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.41,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.01,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.61,
COOPER 6150,4183542,CDM,270,RC,,,outpatient,,,94.65,61.52,,63.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.19,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,75.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,70.99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.92,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,56.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.34,89.92,
COOPER L75-104,4183543,CDM,270,RC,,,outpatient,,,20.58,13.38,,13.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.44,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.49,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.51,19.55,
LOOP ELECTRODE  15X8,4183546,CDM,270,RC,,,outpatient,,,12.63,8.21,,8.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.74,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.38,12,
LOOP ELECTRODE 10X10,4183547,CDM,270,RC,,,outpatient,,,12.63,8.21,,8.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.1,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.47,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.74,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.38,12,
AARON VACUUM,4183549,CDM,270,RC,,,outpatient,,,1.04,0.68,,0.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.83,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.99,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.28,0.99,
BOSTIC 5MM,4183550,CDM,270,RC,,,outpatient,,,277.04,180.08,,185.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,77.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,202.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,249.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,77.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,221.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,207.78,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,78.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,74.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,263.19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,75.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,235.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,166.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.57,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,166.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.16,263.19,
BOSTIC 6-10,4183551,CDM,270,RC,,,outpatient,,,139.54,90.7,,93.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,125.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,111.63,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,104.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.56,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,118.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,83.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.07,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.35,132.56,
EPS11 ELECTROSURGERY PROBE PLUS,4183552,CDM,270,RC,,,outpatient,,,138,89.7,,92.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,124.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,110.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,103.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,36.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,117.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,82.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.94,131.1,
VICRYL 4-0 VCP935H,4183553,CDM,270,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
VICRYL 4-0 J494H,4183554,CDM,270,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
COBAN 2,4183555,CDM,270,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
AIR SPLINT ANKLE LG/RT,4183830,CDM,270,RC,,,outpatient,,,26.5,17.23,,17.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.09,25.18,
AIR SPLINT ANKLE MED/LT,4183831,CDM,270,RC,,,outpatient,,,68,44.2,,45.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.2,64.6,
EAR IRRIGATION,4185040,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
ISOLATION SET UP,4185061,CDM,270,RC,,,outpatient,,,58,37.7,,38.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.53,55.1,
ISOLATION DAILY,4185062,CDM,270,RC,,,outpatient,,,41,26.65,,27.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.98,38.95,
K MODULE SET UP,4185070,CDM,270,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
K MODULE DAILY,4185071,CDM,270,RC,,,outpatient,,,41,26.65,,27.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.98,38.95,
ATERIAL MONITOR SET UP,4185090,CDM,270,RC,,,outpatient,,,202,131.3,,135.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,181.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,56.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,161.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,151.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,57.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,54.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,55.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,171.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.08,191.9,
OXYGEN SET UP,4185110,CDM,270,RC,,,outpatient,,,54,35.1,,36.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,51.3,
PELVIC EXAM KIT,4185120,CDM,270,RC,,,outpatient,,,29.5,19.18,,19.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.9,28.03,
SUCTION GASTRIC,4185220,CDM,270,RC,,,outpatient,,,24.6,15.99,,16.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.14,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.91,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.59,23.37,
SUCTION ORAL,4185230,CDM,270,RC,,,outpatient,,,16,10.4,,10.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.28,15.2,
SIDE RAIL PADS,4185241,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
TRACTION DAILY,4185250,CDM,270,RC,,,outpatient,,,68,44.2,,45.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.2,64.6,
TRACTION SET UP,4185260,CDM,270,RC,,,outpatient,,,54,35.1,,36.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,51.3,
TRAPEZE USE,4185280,CDM,270,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
WALKER USE,4185291,CDM,270,RC,,,outpatient,,,52,33.8,,34.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.92,49.4,
WHIRLPOOL LINERS,4185292,CDM,270,RC,,,outpatient,,,32,20.8,,21.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.57,30.4,
BIOPATCH PROTECTIVE DISK W CHG,4185300,CDM,270,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
TENDERWET ACTIVE DRESSING 1.6  ROUND,4185301,CDM,272,RC,,,outpatient,,,9,5.85,,6.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.41,8.55,
TENDERWET ACTIVE DRESSING 4 x 5,4185302,CDM,272,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
AMBU BAG,4187003,CDM,270,RC,,,outpatient,,,49.5,32.18,,33.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.25,47.03,
C02 DETECTOR,4187014,CDM,270,RC,,,outpatient,,,16.5,10.73,,11.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.42,15.68,
VENTILATOR CIRCUIT,4187018,CDM,270,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
INCENTIVE SPIROMETRY,4187019,CDM,270,RC,,,outpatient,,,119.5,77.68,,80.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,107.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,95.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,89.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,101.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,71.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.99,113.53,
ABG KIT,4187021,CDM,270,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
PEAK FLOW METER,4187023,CDM,270,RC,,,outpatient,,,142,92.3,,95.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,127.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,113.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,106.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,120.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.01,134.9,
"ABDOMINAL BINDER, L",4188800,CDM,270,RC,,,outpatient,,,34,22.1,,22.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,32.3,
"ABDOMINAL BINDER, S",4188801,CDM,270,RC,,,outpatient,,,34,22.1,,22.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,32.3,
"ABDOMINAL BINDER, XL",4188802,CDM,270,RC,,,outpatient,,,34,22.1,,22.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,32.3,
ABDOMINAL BINDER XXL,4188803,CDM,270,RC,,,outpatient,,,34,22.1,,22.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,32.3,
1 CHROMIC S155H,4189016,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 CHROMIC G123H,4189017,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 SILK C013T,4189019,CDM,270,RC,,,outpatient,,,54,35.1,,36.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,51.3,
5-0 SILK N266H,4189020,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
0 SILK A186H,4189021,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
4-0 SILK SA63H,4189022,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
LIGACLIP LS200,4189023,CDM,270,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
4-0 SILK C054T,4189024,CDM,270,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
5-0 CHROMIC U202H,4189025,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
1 PDS Z347H,4189026,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 PDS Z339H,4189027,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
0 PDS Z340H,4189028,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
1 PDS Z879G,4189029,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
2-0 CHROMIC L113G,4189030,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
O CHROMIC L114G,4189031,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 CRON BLUE T1 3090-61,4189033,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
0 CRON BLUE T1 3093-51,4189034,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 CHROMIC L112G,4189036,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 CHROMIC 811H,4189037,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
4-0 DEXON 7728-31,4189038,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
4-0 DEXON 7608-31,4189039,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 PLAIN S102H,4189040,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 PLAIN L102G,4189041,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 CHROMIC G172,4189042,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
3-0 PLAIN E810H,4189043,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 DEXON 7728-41,4189044,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
0-0 PROLENE 8411H,4189045,CDM,270,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
2-0 PLAIN L103G,4189046,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
1 PROLENE 8425H,4189048,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 VICRYL J683H,4189049,CDM,270,RC,,,outpatient,,,64,41.6,,42.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.13,60.8,
1 VICRYL J341H,4189050,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
0 VICRYL J346H,4189051,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 SILK 684H,4189052,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 SILK 685G,4189053,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 VICRYL 316H,4189054,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
6-0 ETHILON 697G,4189056,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
6-0 ETHILON 697H,4189057,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
1 VICRYL J583G,4189059,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
0 VICRYL J740G,4189060,CDM,270,RC,,,outpatient,,,65,42.25,,43.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.4,61.75,
1 CHROMIC 3813H,4189062,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
4-0 SILK K831H,4189063,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 SILK K832H,4189064,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 SILK K833H,4189065,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 PLAIN 843H,4189066,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
1 PROLENE 8424H,4189067,CDM,270,RC,,,outpatient,,,12.6,8.19,,8.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.37,11.97,
2 ETHILON 490T,4189068,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
4-0 ETHILON 1670H,4189069,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 ETHILON 663H,4189070,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 ETHILON 664G,4189072,CDM,270,RC,,,outpatient,,,12.6,8.19,,8.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.37,11.97,
PSW 15 PROXIMATE STAPLER,4189073,CDM,270,RC,,,outpatient,,,110,71.5,,73.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,99,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.45,104.5,
4-0 ETHILON 1667H,4189075,CDM,270,RC,,,outpatient,,,41.5,26.98,,27.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.11,39.43,
5-0 PROLENE 8580H,4189076,CDM,270,RC,,,outpatient,,,74.62,48.5,,50,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,59.7,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.97,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.89,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.89,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.98,70.89,
2-0 PROLENE 8411,4189077,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
5-0 SILK 1678H,4189080,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
4-0 SILK 1687G,4189081,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
1 CHROMIC 813H,4189082,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
3-0 CHROMIC G172H,4189083,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
4-0 CHROMIC 752G,4189084,CDM,270,RC,,,outpatient,,,38.22,24.84,,25.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.58,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.67,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.31,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.49,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.23,36.31,
2-0 PROLENE 8833H,4189085,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 VICRYL J453H,4189086,CDM,270,RC,,,outpatient,,,12.6,8.19,,8.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.37,11.97,
1 PROLENE 8435H,4189088,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
0 PROLENE 8834H,4189092,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
5-0 PROLENE 8756H,4189094,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
UMBILICAL TAPE U11T,4189097,CDM,270,RC,,,outpatient,,,12.6,8.19,,8.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.37,11.97,
LIGACLIP LC-100,4189098,CDM,270,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
BONE WX,4189099,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
LIGACLIP LS 400,4189100,CDM,270,RC,,,outpatient,,,41,26.65,,27.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.98,38.95,
4-0 VICRYL J304H,4189101,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
PSW 35 PROXIMATE STAPLE,4189102,CDM,270,RC,,,outpatient,,,139,90.35,,93.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,125.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,111.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,104.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,118.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.21,132.05,
O CHROMIC 812H,4189103,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
COMPRESSION PLATE,4189104,CDM,270,RC,,,outpatient,,,426,276.9,,285.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,310.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,383.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,118.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,340.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,319.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,120.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,114.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,404.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,362.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,255.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.04,404.7,
NO-LOK SLIDING SCREW,4189105,CDM,270,RC,,,outpatient,,,315,204.75,,211.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,88.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,88.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,229.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,283.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,87.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,252,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,236.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,89.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,84.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,88.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,299.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,86.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,267.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,189,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,189,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.33,299.25,
NO-LOK COMPRESSION SCREW,4189106,CDM,270,RC,,,outpatient,,,32,20.8,,21.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.57,30.4,
0 SURGILON 196962,4189107,CDM,270,RC,,,outpatient,,,41,26.65,,27.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.98,38.95,
3-0 ETHILON 669H,4189108,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 CHROMIC G883H,4189109,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
0 PROLENE 8424H,4189110,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
4-0 DEXON 7232-31,4189111,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
4-0 ETHILON 1629,4189113,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
2-0 PDS Z333H,4189114,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
4-0 VICRYL J422H,4189115,CDM,270,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
3-0 VICRYL J416H,4189116,CDM,270,RC,,,outpatient,,,12.6,8.19,,8.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.37,11.97,
7-0 PROLENE 8708H,4189117,CDM,270,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
4-0 POLYSORB EL 411,4189118,CDM,270,RC,,,outpatient,,,54,35.1,,36.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,51.3,
3-0 POLYSORB EL 410,4189119,CDM,270,RC,,,outpatient,,,54,35.1,,36.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,51.3,
4-0 SOFSILK ES 411,4189120,CDM,270,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
3-0 SOFSILK ES 410,4189121,CDM,270,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
O-CHROMIC SGL-1,4189122,CDM,270,RC,,,outpatient,,,68,44.2,,45.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.2,64.6,
MULTIFIRE GIA 30-V,4189123,CDM,270,RC,,,outpatient,,,477,310.05,,319.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,133.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,348.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,429.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,132.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,381.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,357.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,134.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,127.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,453.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,130.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,405.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,286.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,127.69,453.15,
MULTIFIRE GIA 30-3.5,4189124,CDM,270,RC,,,outpatient,,,468,304.2,,313.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,131.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,131.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,341.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,421.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,130.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,374.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,351,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,132.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,125.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,131.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,444.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,127.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,397.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,280.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,280.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,125.28,444.6,
4-0 PDS Z304H,4189125,CDM,270,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
LDS-15W TIT STAPLER,4189126,CDM,270,RC,,,outpatient,,,777,505.05,,520.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,217.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,208,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,217.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,567.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,699.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,216.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,621.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,582.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,219.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,208,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,217.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,738.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,212.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,660.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,466.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,466.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,208,738.15,
MULTIFIRE GIA RELOAD (BLUE),4189127,CDM,270,RC,,,outpatient,,,941,611.65,,630.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,263.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,263.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,686.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,846.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,261.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,752.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,705.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,266.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,251.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,263.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,893.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,256.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,799.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,564.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,263.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,564.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,251.91,893.95,
MULTF TA55-3.5,4189128,CDM,270,RC,,,outpatient,,,433,281.45,,290.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,389.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,120.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,346.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,324.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,122.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,411.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,368.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,115.91,411.35,
TA 55.35 RELOAD,4189129,CDM,270,RC,,,outpatient,,,246,159.9,,164.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,179.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,221.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,68.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,196.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,184.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,233.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,209.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.85,233.7,
MULTF GIA 60,4189130,CDM,270,RC,,,outpatient,,,502,326.3,,336.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,140.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,366.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,451.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,139.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,401.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,376.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,141.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,134.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,476.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,137.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,426.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,301.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,301.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.39,476.9,
GIA 60 RELOAD,4189131,CDM,270,RC,,,outpatient,,,283,183.95,,189.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,254.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,226.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,212.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.76,268.85,
SURGITIE 018 SGL2,4189133,CDM,270,RC,,,outpatient,,,208,135.2,,139.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,58.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,151.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,187.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,57.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,166.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,156,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,58.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,55.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,197.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,56.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,176.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.68,197.6,
2-0 VICRYL J417H,4189134,CDM,270,RC,,,outpatient,,,12.6,8.19,,8.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.34,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.53,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.37,11.97,
4-0 VICRYL J507G,4189135,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
6-0 PROLENE 8610H,4189136,CDM,270,RC,,,outpatient,,,47,30.55,,31.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,42.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,37.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,35.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.58,44.65,
4-0 PROLENE 8683G,4189137,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
TS1 LIGATURE DIVICE,4189138,CDM,270,RC,,,outpatient,,,168,109.2,,112.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,122.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,151.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,46.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,134.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,126,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,159.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,142.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.97,159.6,
SKIN-STAPLE DS-5,4189140,CDM,270,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
DISP. TA LONG 90,4189141,CDM,270,RC,,,outpatient,,,301,195.65,,201.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,84.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,84.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,219.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,270.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,83.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,240.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,225.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,85.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,80.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,84.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,285.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,82.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,255.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,180.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,180.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.58,285.95,
3-0 VICRYL J110T,4189143,CDM,270,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
3-0 VICRYL J910T,4189144,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
2-0 VICRYL J111T,4189145,CDM,270,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
2-0 VICRYL J911T,4189146,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
4-0 SILK C014,4189147,CDM,270,RC,,,outpatient,,,24,15.6,,16.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.42,22.8,
ROYAL 35W SKIN STAPLES,4189148,CDM,270,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
VERSPRT 5-11MM,4189149,CDM,270,RC,,,outpatient,,,207,134.55,,138.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,57.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,151.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,186.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,57.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,165.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,155.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,58.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,55.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,196.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,56.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,175.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.41,196.65,
SPRING-GRIP 5MM,4189150,CDM,270,RC,,,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.35,19,
SPRING-GRIP 5MM-11MM,4189151,CDM,270,RC,,,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.35,19,
L3 POLSORB,4189152,CDM,270,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
L2 POLSORB,4189153,CDM,270,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
VERSPIT 5MM,4189157,CDM,270,RC,,,outpatient,,,162,105.3,,108.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,45.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,45.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,145.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,129.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,121.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,45.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,43.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,45.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,153.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,44.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,137.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.37,153.9,
2-0 SILK C012T,4189160,CDM,270,RC,,,outpatient,,,40,26,,26.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,38,
ORIGIN #10 TROCAR,4189163,CDM,270,RC,,,outpatient,,,141,91.65,,94.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.75,133.95,
ORIGIN #10 GRIPPERS,4189164,CDM,270,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
V.U.M. #5 TROCAR KNIFE,4189165,CDM,270,RC,,,outpatient,,,62,40.3,,41.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.6,58.9,
ORIGIN ACUCLIP,4189166,CDM,270,RC,,,outpatient,,,284,184.6,,190.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,207.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,255.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,79.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,227.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,213,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,76.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,269.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,241.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,170.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,170.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.03,269.8,
TROCAR 5MM/60,4189167,CDM,270,RC,,,outpatient,,,62,40.3,,41.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.6,58.9,
CURVED SCISSORS 5mm,4189168,CDM,270,RC,,,outpatient,,,201,130.65,,134.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,180.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,160.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,150.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.81,190.95,
BLUNT TIP TROCAR 10mm,4189170,CDM,270,RC,,,outpatient,,,252,163.8,,168.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,70.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,70.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,183.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,226.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,70.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,201.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,189,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,71.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,67.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,70.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,239.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,68.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,214.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,151.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,151.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.46,239.4,
G-TUBE 18 FR,4189171,CDM,270,RC,,,outpatient,,,59,38.35,,39.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,53.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.79,56.05,
G-TUBE 12/28FR,4189172,CDM,270,RC,,,outpatient,,,381,247.65,,255.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,106.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,106.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,278.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,342.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,106.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,304.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,285.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,107.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,101.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,106.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,361.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,104.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,323.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,228.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,228.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,101.99,361.95,
6-0 PROLENE 8697G,4189174,CDM,270,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
3-0 VICRYL J258H,4189176,CDM,270,RC,,,outpatient,,,9,5.85,,6.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.41,8.55,
4-0 PROLENE 8682G,4189177,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
5-0 MONOCRYL Y493G,4189178,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
4-0 MONOCRYL Y496G,4189179,CDM,270,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
3-0 VICRYL J285G,4189181,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
2-0 NUROLON C546D,4189182,CDM,270,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
1 VICRYL J741D,4189183,CDM,270,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
4-0 VICRYL J743D,4189184,CDM,270,RC,,,outpatient,,,61,39.65,,40.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.33,57.95,
1 PROLENE 8824G,4189186,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
2-0 PROLENE 8423H,4189187,CDM,270,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
5-0 ETHILON 1666H,4189190,CDM,270,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
4-0 VICRYL J415H,4189191,CDM,270,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
0 CHROMIC ENDOLOOP 18  EL20G,4189192,CDM,270,RC,,,outpatient,,,62,40.3,,41.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.6,58.9,
2-0 PROLENE 8417H,4189194,CDM,270,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
GASTROSTOMY TUBE 20FR,4189849,CDM,270,RC,,,outpatient,,,84,54.6,,56.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,67.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.49,79.8,
1/2 NORMAL SALINE 1000ML,4210001,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
1/2 NORMAL SALINE 500ML,4210002,CDM,258,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
D10W 1000ML,4210003,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
D5 1/2 NS W/KCL 20mEq/LITER 1000ML,4210004,CDM,258,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
D5 1/2 NORMAL SALINE 1000ML,4210005,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
D5 1/2 NORMAL SALINE 500ML,4210007,CDM,258,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
D5 1/4 NORMAL SALINE 1000ML,4210011,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
D5 1/4 NORMAL SALINE 500ML,4210013,CDM,258,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
D5NS 1000ML,4210014,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
D5RL 1000ML,4210015,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
D5W 1000ML,4210017,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NORMAL SALINE 1000ML,4210020,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
NORMAL SALINE 500ML,4210022,CDM,250,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
LACTATED RINGERS 1000ML,4210023,CDM,258,RC,,,outpatient,,,60,39,,40.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.06,57,
RINGERS LACTATE 500ML,4210024,CDM,258,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
NORMAL SALINE W/20mEq KCL 1000ml,4210025,CDM,258,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
NORMAL SALINE W/40mEq KCL 1000ML,4210026,CDM,258,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
D5NS W/KCL 20mEq/LITER 1000 ML,4210031,CDM,258,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
D5 1/2 NS W/KCL 10mEq/LITER 1000ML,4210032,CDM,258,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
D5 1/2 NS W/KCL 40mEq/LITER 1000 ML,4210034,CDM,258,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
ANESTHESIA FOR SCREENING COLONOSCOPY,4220040,CDM,964,RC,,,outpatient,,,56,36.4,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
ANESTHESIA FOR  UPPER & LOWER GI ENDO,4220045,CDM,964,RC,,,outpatient,,,42.5,27.63,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
HEAD (SALIVARY GLANDS),4220050,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"HEAD (EAR, EXT,MID,INNER INCLUD BIOPSY)",4220051,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
HEAD (PROCEDURES NOSE & ACCESS SINUSES),4220052,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
HEAD (BIOPSY SOFT TISSUE),4220053,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
HEAD (INTRAORAL PROCEDURES INCL BIOPSY),4220054,CDM,964,RC,,,outpatient,,,63.5,41.28,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
NECK (INTEGUMENTARY),4220055,CDM,964,RC,,,outpatient,,,9,5.85,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"NECK (ESOPHAGUS,THROAT,LARYNYX,TRACH)",4220056,CDM,964,RC,,,outpatient,,,55.5,36.08,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
NECK (NEEDLE BIOPSY OF THYROID),4220057,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
ANESTHESIA OTOSCOPY,4220058,CDM,370,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
THORAX (ELECTRICAL CONVERSION OF ARRHYTH,4220059,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INTRATHORACIC (ESOPHAGUS),4220061,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INTRATHORACIC (CLOSED CHEST PROCEDURES),4220062,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INTRATHORACIC (NEEDLE BIOPSY OF PLEURA),4220063,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INTRATHORACIC (PNEUMOCENTESIS),4220064,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INTRATHORACIC (ACCESS TO CENTRAL VEN CIR,4220065,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ABD(ANTERIOR ABD WALL),4220066,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ABD(PERCUTANEOUS LIVER BIOPSY,4220067,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ABDOMEN (POSTERIOR ABD WALL),4220068,CDM,964,RC,,,outpatient,,,28,18.2,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ABD(HERNIA REPAIRS),4220070,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ABD(LUMBAR & VENTRAL HERN DEH),4220071,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ABD(OMPHALOCELE),4220072,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ABD(INTRAPERITONEAL PROCEDURE,4220073,CDM,964,RC,,,outpatient,,,64,41.6,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER ABD(ANTERIOR ABD WALL),4220074,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER ABD(INTESTINAL ENDO PROCEDURE,4220075,CDM,964,RC,,,outpatient,,,29.5,19.18,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER ABD(POSTERIOR),4220076,CDM,964,RC,,,outpatient,,,46,29.9,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER ABD(HERNIA REPAIRS),4220077,CDM,964,RC,,,outpatient,,,23,14.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER ABD(VENTRAL & INCISIONAL HERN),4220078,CDM,964,RC,,,outpatient,,,7.5,4.88,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER ABD(INTRAPERITONEAL),4220079,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER ABD(ABDO/PERINEAL RESECTION),4220080,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER ABD(RADICAL HYSTERECTOMY),4220081,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER ABD(EXTRAPERITONEAL),4220082,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
TRANSURETHRAL PROCEDURES,4220083,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PERINEUM (ANORECTAL),4220084,CDM,964,RC,,,outpatient,,,15,9.75,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PERINEUM (MALE GENITALIA),4220085,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PERINEUM (UNDESC TESTIS UNILAT OT BILAT),4220086,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"PERINEUM (RADICAL ORCHIECTOMY,INGUINAL)",4220087,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PERINEUM (RADICAL ORCHIECTOMY ABDOMINAL),4220088,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"PERINEUM (ORCHIOPEXY,UNI & BILAT)",4220089,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PERINEUM (VAGINAL PROCEDURES),4220090,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
COLPOTOMY VAGINECTOMY COLPORRHAPHY,4220091,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PERINEUM (VAGINAL HYSTERECTOMY),4220092,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PERINEUM SEMINAL VESICLES,4220094,CDM,964,RC,,,outpatient,,,99,64.35,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PERINEUM (HYSTEROSCOPY &/OR HYSTERSA,4220096,CDM,370,RC,,,outpatient,,,98,63.7,,65.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.23,93.1,
UPPER LEG EXCEPT KNEE (AMPUTATION),4220097,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER LEG EXCEPT KNEE INCLUDING EXPLORAT,4220098,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
KNEE & POPLITEAL (DISARTICULATION KNEE),4220100,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
KNEE & POPLITEAL (CAST APP/REMOV/REPAIR),4220101,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER LEG BELOW KNEE (OPEN PROCEDURES),4220103,CDM,964,RC,,,outpatient,,,63.5,41.28,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"LOWER LEG BELOW KNEE (CAST APP/REMOV,REP",4220104,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
THORAX CLAVICLE & SCAPULA,4220106,CDM,964,RC,,,outpatient,,,58.8,38.22,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
THORAX (INTEGUMENTARY SYSTEM),4220107,CDM,964,RC,,,outpatient,,,58.8,38.22,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UNLISTED ANESTHESIA PROCEDURE(S),4220109,CDM,964,RC,,,outpatient,,,24.5,15.93,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PATIENT OF EXTREME AGE(<1yr & >70),4220115,CDM,964,RC,,,outpatient,,,13.5,8.78,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
COMPLICATION OF TOTAL BODY HYPOTHERMIA,4220116,CDM,964,RC,,,outpatient,,,679.5,441.68,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
COMPLICATION OF CONTROLLED HYPOTENSION,4220117,CDM,964,RC,,,outpatient,,,679.5,441.68,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
COMPLICATIONS BY EMERGENCY CONDITIONS,4220118,CDM,964,RC,,,outpatient,,,182.4,118.56,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER LEG EXCEPT KNEE (OPEN PROCEDURES),4220119,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LOWER LEG BELOW KNEE (RADICAL RESECTION),4220120,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"UPPER ARM AND ELBOW (NERVES,MUSCLE,TEND)",4220121,CDM,370,RC,,,outpatient,,,98,63.7,,65.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.23,93.1,
INJECTION DIAG/THERA ANEST OR ANTISPASM,4220122,CDM,964,RC,,,outpatient,,,1082.5,703.63,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ARM & ELBOW (OPEN PROCEDURES),4220123,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"LOWER LEG BELOW KNEE (NERVES,MUSC,TEN FA",4220125,CDM,964,RC,,,outpatient,,,15,9.75,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
THORAX (RADICAL OR MODIFIED BREAST),4220126,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"KNEE & POPLITEAL, ALL PROCEDURES",4220129,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
KNEE & POPLITEAL OPEN PROCEDURE LOW 1/3,4220130,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
FOREARM WRIST HAND (OPEN PROCEDURES),4220131,CDM,964,RC,,,outpatient,,,35.5,23.08,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
FOREARM WRIST & HAND (VASC SHUNT/REVISIO,4220132,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ARM & ELBOW (ARTERIES),4220134,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER ARM & ELBOW (VEINS),4220136,CDM,964,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"UPPER LEG (EXCEPT KNEE) NERVES,MUSCLE,TE",4220138,CDM,964,RC,,,outpatient,,,127.5,82.88,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UPPER GI ENDOSCOPIC PROCEDURE PROX TO DU,4220139,CDM,964,RC,,,outpatient,,,28.5,18.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
ECHO TRANSTHORACIC COMP W/DOP & COLOR,4250000,CDM,483,RC,,,outpatient,,,371,241.15,,248.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,103.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,270.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,333.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,103.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,296.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,278.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,104.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,99.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,352.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,101.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,315.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,222.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,222.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,99.32,352.45,
ECHO TRANSTHORACIC FOLLOW-UP OR LIMITED,4250002,CDM,480,RC,,,outpatient,,,638,414.7,,427.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,170.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,465.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,574.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,177.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,510.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,478.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,180.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,170.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,606.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,174.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,542.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,382.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,382.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.79,606.1,
US BLADDER CAPACITY OR POST VOID RESID,4251798,CDM,360,RC,,,outpatient,,,100,65,,67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.77,95,
XR CHEST 2 VIEWS FRONTAL & LATERAL,4280001,CDM,324,RC,,,outpatient,,,185,120.25,,123.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,166.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,51.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,138.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,52.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,49.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,175.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,50.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,157.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.52,175.75,
XR RIBS W/ PA CHEST MIN 3 VWS,4280002,CDM,320,RC,,,outpatient,,,148,96.2,,99.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,41.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,133.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,41.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,118.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,111,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,40.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,125.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.62,140.6,
XR BIL RIBS W/ PA CHEST MIN 4 VWS,4280003,CDM,320,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
XR STERNUM 2 VIEWS,4280004,CDM,320,RC,,,outpatient,,,153,99.45,,102.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,137.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,122.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,114.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,130.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.96,145.35,
XR CHEST 2 VIEWS WITH FLOUROSCOPY,4280006,CDM,324,RC,,,outpatient,,,169.65,110.27,,113.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,152.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,47.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,135.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,127.24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,144.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.42,161.17,
XR STERNOCLAVICULAR JT MIN 3 VWS,4280007,CDM,320,RC,,,outpatient,,,153,99.45,,102.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,137.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,122.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,114.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,130.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.96,145.35,
XR CHEST SINGLE VIEW FRONTAL,4280009,CDM,324,RC,,,outpatient,,,112.5,73.13,,75.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,101.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,90,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.12,106.88,
XR CHEST COMPLETE 4 VIEWS WITH FLUROSCOP,4280010,CDM,324,RC,,,outpatient,,,169.65,110.27,,113.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,152.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,47.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,135.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,127.24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,144.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.42,161.17,
XR ABDOMEN SINGLE ANTEROPOSTERIOR VIEW,4280013,CDM,320,RC,,,outpatient,,,321,208.65,,215.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,89.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,89.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,288.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,89.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,256.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,240.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,90.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,85.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,89.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,304.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,87.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,272.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,192.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,192.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.93,304.95,
XR ABD COMPLETE INCL DECUB & OR ERECT,4280014,CDM,320,RC,,,outpatient,,,100,65,,67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.77,95,
XR ACUTE ABD SER SUP/ERECT UPRIGHT PA CH,4280015,CDM,320,RC,,,outpatient,,,150.5,97.83,,100.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,135.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,41.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,120.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,112.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,42.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,127.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,90.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.29,142.98,
XR SPINE CERVICAL COMPLETE OBLIQUE & FLE,4280017,CDM,320,RC,,,outpatient,,,745,484.25,,499.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,208.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,543.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,670.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,207.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,596,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,558.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,210.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,199.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,707.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,203.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,633.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,447,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,447,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,203.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,199.44,707.75,
XA BARIUM SWALLOW,4280018,CDM,320,RC,,,outpatient,,,103.5,67.28,,69.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,93.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,82.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,77.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,87.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,62.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.71,98.33,
XA GI TRACT UPPER W/O KUB,4280019,CDM,320,RC,,,outpatient,,,140,91,,93.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.48,133,
XA GI TRACT UPPER W/SMALL BOWEL,4280020,CDM,320,RC,,,outpatient,,,140,91,,93.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.48,133,
XA BARIUM ENEMA,4280021,CDM,320,RC,,,outpatient,,,173,112.45,,115.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,48.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,155.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,48.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,138.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,129.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,48.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,46.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,47.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,147.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.31,164.35,
XA BARIUM ENEMA AIR CON,4280022,CDM,320,RC,,,outpatient,,,288,187.2,,192.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,259.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,230.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,273.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,244.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.1,273.6,
XR UROGRAPHY PYELOGRAPHY IV,4280029,CDM,320,RC,,,outpatient,,,576.5,374.73,,386.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,161.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,154.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,161.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,420.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,518.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,160.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,461.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,432.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,163.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,154.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,161.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,547.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,157.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,490.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,345.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,345.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,154.33,547.68,
XR FACIAL BONES COMPLETE 3 VIEWS,4280034,CDM,320,RC,,,outpatient,,,131,85.15,,87.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,98.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.07,124.45,
XR NASAL BONES COMPLETE 3 VIEWS,4280035,CDM,320,RC,,,outpatient,,,42,27.3,,28.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.24,39.9,
XR SELLA TURCICA,4280037,CDM,320,RC,70240,HCPCS,outpatient,,,153,99.45,,102.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.24,208,,,fee schedule,208% BCBS PPO fee schedule,137.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,122.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,114.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,130.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.96,145.35,
XR MASTOIDS COMPLETE 3 VIEWS PER SIDE,4280038,CDM,320,RC,,,outpatient,,,288,187.2,,192.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,259.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,230.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,273.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,244.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.1,273.6,
XR SINUSES PARANASAL COMPLETE 3 VIEWS,4280039,CDM,320,RC,,,outpatient,,,184,119.6,,123.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,165.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,51.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,147.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,138,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,52.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,49.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,174.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,50.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,156.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,110.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.26,174.8,
XR ORBITS COMPLETE 4 VIEWS,4280040,CDM,320,RC,,,outpatient,,,282,183.3,,188.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,78.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,205.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,253.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,225.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,211.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,79.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,267.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,239.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.49,267.9,
XR MANDIBLE COMPLETE 4 VIEWS,4280041,CDM,320,RC,,,outpatient,,,98.5,64.03,,66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.37,93.58,
XR TEMPOROMANDIBU JOINT OPEN/CLOSED BILA,4280042,CDM,320,RC,,,outpatient,,,153,99.45,,102.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,137.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,122.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,114.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,130.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.96,145.35,
XR SKULL LESS THAN 4 VIEWS,4280043,CDM,320,RC,,,outpatient,,,41,26.65,,27.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.98,38.95,
XR SKULL COMPLETE 4 VIEWS,4280044,CDM,320,RC,,,outpatient,,,498.5,324.03,,334,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,139.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,139.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,363.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,448.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,138.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,398.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,373.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,140.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,133.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,139.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,473.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,136.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,423.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,299.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,139.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,299.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,133.45,473.58,
XR SPINE CERVICAL MIN 4 VWS,4280045,CDM,320,RC,,,outpatient,,,791,514.15,,529.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,221.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,211.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,221.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,577.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,711.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,220.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,632.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,593.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,223.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,211.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,221.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,751.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,215.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,672.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,474.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,474.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,211.75,751.45,
XR SPINE CERVICAL 2 0R 3 VWS,4280046,CDM,320,RC,,,outpatient,,,436.5,283.73,,292.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,122.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,116.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,122.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,318.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,392.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,121.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,349.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,327.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,123.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,116.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,122.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,414.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,119.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,371.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,261.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,261.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,116.85,414.68,
XR SPINE SGL VW SPECIFY LEVEL,4280047,CDM,320,RC,,,outpatient,,,153,99.45,,102.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,137.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,122.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,114.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,130.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.96,145.35,
XR SPINE THORACIC 3 VIEWS,4280048,CDM,320,RC,,,outpatient,,,629,408.85,,421.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,176.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,168.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,459.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,566.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,175.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,503.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,471.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,177.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,168.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,597.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,171.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,534.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,377.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,377.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,168.38,597.55,
XR SPINE THORACIC 2 VIEWS,4280049,CDM,320,RC,,,outpatient,,,136,88.4,,91.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,122.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,108.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,102,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,38.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,36.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,115.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.41,129.2,
XR OSSEOUS SURVEY LIMIT,4280050,CDM,320,RC,,,outpatient,,,288,187.2,,192.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,259.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,230.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,273.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,244.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.1,273.6,
XR VENOGRAPHY EXTREMITY UNILAT,4280052,CDM,320,RC,,,outpatient,,,1744.5,1133.93,,1168.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,488.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,467,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,488.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1273.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1570.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,485.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1395.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1308.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,493.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,467,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,488.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1657.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,476.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1482.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1046.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,488.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1046.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,476.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,467,1657.28,
XR VENOGRAPHY EXTREMITY BI,4280053,CDM,320,RC,,,outpatient,,,1744.5,1133.93,,1168.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,488.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,467,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,488.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1273.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1570.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,485.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1395.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1308.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,493.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,467,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,488.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1657.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,476.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1482.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1046.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,488.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1046.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,476.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,467,1657.28,
MM MAMMO EXAM SURGICAL SPECIMEN,4280057,CDM,401,RC,,,outpatient,,,1146.5,745.23,,768.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,321.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,306.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,321.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,836.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1031.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,319.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,917.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,859.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,324.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,306.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,321.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1089.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,313.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,974.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,687.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,321.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,687.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,313.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,306.92,1089.18,
XR SPINE LUMBOSACRAL MIN 4 VWS,4280060,CDM,320,RC,,,outpatient,,,581,377.65,,389.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,162.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,155.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,162.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,424.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,522.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,161.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,464.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,435.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,164.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,155.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,162.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,551.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,158.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,493.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,348.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,348.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,158.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.53,551.95,
XR SPINE LUMBOSACRAL 2 OR 3 VWS,4280061,CDM,320,RC,,,outpatient,,,420,273,,281.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,306.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,378,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,336,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,315,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,399,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,357,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.43,399,
XR SACRUM OR COCCYX MIN 2 VWS,4280062,CDM,320,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
XR SACROILIAC JOINTS 3 OR MORE VIEWS,4280064,CDM,320,RC,,,outpatient,,,103.5,67.28,,69.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,93.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,82.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,77.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,87.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,62.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.71,98.33,
XR HAND 2 VIEWS LEFT,4280065,CDM,320,RC,,,outpatient,,,247,160.55,,165.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,69.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,69.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,180.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,222.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,68.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,197.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,185.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,66.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,69.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,209.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,66.12,234.65,
XR FINGERS MIN 2 VWS,4280066,CDM,320,RC,,,outpatient,,,413,268.45,,276.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,115.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,115.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,301.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,371.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,114.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,330.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,309.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,116.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,110.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,115.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,392.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,112.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,351.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.56,392.35,
XR WRIST 3 VIEWS LEFT,4280067,CDM,320,RC,,,outpatient,,,155,100.75,,103.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,139.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,124,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,116.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,131.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.49,147.25,
XR FOREARM 2 VIEWS LEFT,4280068,CDM,320,RC,,,outpatient,,,262.5,170.63,,175.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,73.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,236.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,73.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,210,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,196.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,249.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,71.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,223.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,157.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.27,249.38,
XR ELBOW 3 VIEWS LEFT,4280069,CDM,320,RC,,,outpatient,,,501,325.65,,335.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,140.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,365.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,450.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,139.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,400.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,375.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,141.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,134.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,475.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,136.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,425.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,300.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,300.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.12,475.95,
XR HUMERUS 2 VIEWS LEFT,4280070,CDM,320,RC,,,outpatient,,,526.5,342.23,,352.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,147.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,147.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,384.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,473.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,146.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,421.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,394.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,148.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,140.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,147.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,500.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,143.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,447.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,315.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,315.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,143.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.94,500.18,
XR SHOULDER 2 VIEWS LEFT,4280071,CDM,320,RC,,,outpatient,,,632,410.8,,423.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,176.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,461.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,568.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,175.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,505.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,474,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,178.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,169.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,600.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,172.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,537.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,379.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,379.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,172.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,169.19,600.4,
XR A-C JOINTS BILATERAL,4280072,CDM,320,RC,,,outpatient,,,67.5,43.88,,45.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,60.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,50.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.07,64.13,
XR SCAPULA COMPLETE LEFT,4280073,CDM,320,RC,,,outpatient,,,145.5,94.58,,97.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,130.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,116.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,109.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,123.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,87.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.95,138.23,
XR CLAVICLE COMPLETE LEFT,4280074,CDM,320,RC,,,outpatient,,,88.5,57.53,,59.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,53.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.69,84.08,
XR FOOT COMPLETE 3 VIEWS LEFT,4280075,CDM,320,RC,,,outpatient,,,246,159.9,,164.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,179.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,221.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,68.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,196.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,184.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,233.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,209.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.85,233.7,
XR HEEL (CALCANEUS) 2 VIEWS LEFT,4280076,CDM,320,RC,,,outpatient,,,264.5,171.93,,177.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,193.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,238.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,73.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,211.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,198.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,72.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,224.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,158.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,158.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.81,251.28,
XR ANKLE 3 VIEWS LEFT,4280077,CDM,320,RC,,,outpatient,,,532,345.8,,356.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,388.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,478.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,148.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,425.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,399,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,150.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,142.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,505.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,145.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,452.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,319.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,319.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,142.42,505.4,
XR TIBIA/FIBULA 2 VIEWS LEFT,4280078,CDM,320,RC,,,outpatient,,,288.5,187.53,,193.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,259.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,230.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,274.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,245.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,173.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.23,274.08,
XR KNEE 3 VIEWS LEFT,4280079,CDM,320,RC,,,outpatient,,,133.5,86.78,,89.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,120.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,100.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,80.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.74,126.83,
XR KNEE FOUR OR MORE VIEWS LEFT,4280080,CDM,320,RC,,,outpatient,,,215.5,140.08,,144.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,60.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,193.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,60,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,172.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,161.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,60.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,57.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,204.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,58.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,183.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,129.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.69,204.73,
XR FEMUR 2 VIEWS LEFT,4280081,CDM,320,RC,,,outpatient,,,95.5,62.08,,63.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,71.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.57,90.73,
XR PELVIS 1 OR 2 VIEWS,4280082,CDM,320,RC,,,outpatient,,,53,34.45,,35.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.19,50.35,
XR HIP UNILATERAL 2-3 VIEWS LEFT,4280083,CDM,320,RC,,,outpatient,,,205.5,133.58,,137.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,184.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,57.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,164.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,154.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,58.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,55.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,195.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,56.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,174.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,123.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.01,195.23,
XR SHOULDER ARTHROGRAM,4280087,CDM,320,RC,,,outpatient,,,337.5,219.38,,226.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,94.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,246.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,303.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,93.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,270,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,253.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,95.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,90.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,320.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,92.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,286.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,202.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,202.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,90.35,320.63,
CT PROCEDURE UNLISTED,4280098,CDM,359,RC,,,outpatient,,,936.5,608.73,,627.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,262.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,250.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,262.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,683.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,842.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,260.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,749.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,702.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,264.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,250.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,262.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,889.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,255.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,796.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,561.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,561.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,250.7,889.68,
XR FOOT COMPLETE 3 VIEWS RIGHT,4280127,CDM,320,RC,,,outpatient,,,246,159.9,,164.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,179.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,221.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,68.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,196.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,184.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,233.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,209.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.85,233.7,
US BREASTS UNILATERAL\ BILATERAL,4280128,CDM,402,RC,,,outpatient,,,667,433.55,,446.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,186.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,186.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,486.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,600.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,185.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,533.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,500.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,188.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,178.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,186.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,633.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,182.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,566.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,400.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,400.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,178.56,633.65,
US LIMITED 1 ORGAN F/UP,4280129,CDM,402,RC,,,outpatient,,,1003.5,652.28,,672.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,280.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,280.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,732.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,903.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,279.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,802.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,752.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,283.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,268.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,280.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,953.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,274.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,852.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,602.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,280.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,602.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,268.64,953.33,
US RETROPERITONEAL COMPLETE,4280130,CDM,402,RC,,,outpatient,,,138.5,90.03,,92.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,124.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,110.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,103.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,117.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,83.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.08,131.58,
US PREGNANT UTERUS COMP <14wks0days,4280131,CDM,402,RC,,,outpatient,,,397.5,258.38,,266.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,111.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,111.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,290.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,357.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,110.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,318,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,298.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,112.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,106.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,111.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,377.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,108.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,337.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,238.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,238.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,106.41,377.63,
US CHEST,4280132,CDM,402,RC,,,outpatient,,,164.5,106.93,,110.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,131.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,44.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,139.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,98.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.04,156.28,
US PELVIC NONOBSTETRIC COMPLETE,4280135,CDM,402,RC,,,outpatient,,,306,198.9,,205.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,85.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,223.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,275.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,85.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,244.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,229.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,86.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,81.92,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,290.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,83.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,260.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,183.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,183.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.92,290.7,
US PREGNANT UTERUS COMPL > 14wks0day,4280136,CDM,402,RC,,,outpatient,,,392.5,255.13,,262.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,353.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,109.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,314,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,294.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,111,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,105.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,372.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,107.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,333.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,235.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,235.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,105.07,372.88,
US SOFT TISSUES HEAD & NECK,4280137,CDM,402,RC,,,outpatient,,,1299.5,844.68,,870.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,363.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,347.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,363.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,948.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1169.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,361.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1039.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,974.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,367.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,347.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,363.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1234.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,354.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1104.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,779.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,363.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,779.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,354.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,347.88,1234.53,
XR OSSEOUS SURVEY COMP,4280149,CDM,320,RC,,,outpatient,,,288,187.2,,192.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,259.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,230.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,273.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,244.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.1,273.6,
XR OSSEOUS SURVEY INFANT,4280150,CDM,320,RC,,,outpatient,,,174.5,113.43,,116.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,48.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,157.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,48.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,139.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,130.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,46.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,165.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,47.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,148.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,104.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.71,165.78,
US SCROTUM & CONTENTS,4280151,CDM,402,RC,,,outpatient,,,996,647.4,,667.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,278.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,266.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,278.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,727.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,896.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,277.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,796.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,747,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,281.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,266.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,278.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,946.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,271.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,846.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,597.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,597.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,271.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,266.63,946.2,
US TRANSVAGINAL,4280152,CDM,402,RC,,,outpatient,,,648,421.2,,434.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,181.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,181.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,473.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,583.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,180.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,518.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,486,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,183.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,173.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,181.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,615.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,176.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,550.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,388.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,181.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,388.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,173.47,615.6,
US EXTREMITY NONVASCULAR,4280153,CDM,402,RC,,,outpatient,,,91,59.15,,60.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.36,86.45,
XR LOWER EXTREMITY INFANT TWO VIEWS,4280155,CDM,320,RC,,,outpatient,,,89.4,58.11,,59.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,80.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,71.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.93,84.93,
XR DUP SCAN ABD PELV SCROTAL &OR RETROPE,4280156,CDM,921,RC,,,outpatient,,,473.5,307.78,,317.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,132.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,132.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,345.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,426.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,131.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,378.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,355.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,133.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,126.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,132.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,449.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,129.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,402.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,284.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,284.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,126.76,449.83,
XR LOW EXTREMITY RIGHT INFANT TWO VIEWS,4280157,CDM,320,RC,,,outpatient,,,89.4,58.11,,59.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,80.46,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,71.52,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.05,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.93,84.93,
XR UPPER EXTREMITY LEFT INFANT TWO VIEWS,4280158,CDM,320,RC,,,outpatient,,,142,92.3,,95.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,127.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,113.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,106.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,120.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.01,134.9,
XR UPP EXTREMITY RIGHT INFANT TWO VIEWS,4280159,CDM,320,RC,,,outpatient,,,142,92.3,,95.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,127.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,113.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,106.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,120.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.01,134.9,
XR SCOLIOSIS STUDY SPINE & EREC,4280174,CDM,320,RC,,,outpatient,,,57.5,37.38,,38.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.39,54.63,
US ULTRASONIC GUIDANCE FOR NEEDLE PLACE,4280175,CDM,402,RC,,,outpatient,,,483.5,314.28,,323.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,352.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,435.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,134.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,386.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,362.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,136.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,129.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,459.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,132.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,410.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,290.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,290.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,129.43,459.33,
US PREGNANT UTERUS FOLLOW UP RE EVAL,4280179,CDM,402,RC,,,outpatient,,,132.5,86.13,,88.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,119.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.47,125.88,
US ABD COMPLETE,4280180,CDM,402,RC,,,outpatient,,,491,319.15,,328.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,137.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,137.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,358.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,441.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,136.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,392.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,368.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,138.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,131.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,137.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,466.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,134.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,417.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,294.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,294.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,134.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,131.44,466.45,
US ULTRASONIC GUIDANCE FOR AMNIOCENTESIS,4280181,CDM,402,RC,,,outpatient,,,314.5,204.43,,210.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,88.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,88.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,229.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,283.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,87.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,251.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,235.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,88.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,84.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,88.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,298.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,85.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,267.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,188.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,188.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.19,298.78,
US PREGNANT UTERUS ECH ADD'L GESTATIO,4280182,CDM,402,RC,,,outpatient,,,304,197.6,,203.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,85.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,221.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,273.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,84.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,243.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,228,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,85.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,81.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,85.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,288.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,83.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,258.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.38,288.8,
US PREGANT UTERUS LIMITED,4280183,CDM,402,RC,,,outpatient,,,98.5,64.03,,66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.37,93.58,
XR BONE AGE STUDIES,4280185,CDM,320,RC,,,outpatient,,,43.5,28.28,,29.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.64,41.33,
XR SINUSES PARANASAL LIMITED 2 VIEWS,4280186,CDM,320,RC,,,outpatient,,,69,44.85,,46.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,62.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,55.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.47,65.55,
XR SPINE LUMBOSACRAL COMPLETE W/FLEXION,4280187,CDM,320,RC,,,outpatient,,,629,408.85,,421.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,176.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,168.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,459.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,566.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,175.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,503.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,471.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,177.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,168.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,597.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,171.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,534.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,377.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,377.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,168.38,597.55,
XR SPINE ENTIRE SURVEY AP LAT,4280188,CDM,320,RC,,,outpatient,,,217.5,141.38,,145.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,60.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,158.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,195.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,60.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,174,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,163.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,61.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,58.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,59.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,184.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,130.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,130.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.22,206.63,
XR WRIST 2 VIEWS LEFT,4280189,CDM,320,RC,,,outpatient,,,101,65.65,,67.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.04,95.95,
XR FOOT COMPLETE TWO VIEWS RT,4280190,CDM,320,RC,,,outpatient,,,335,217.75,,224.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,244.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,301.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,93.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,268,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,251.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,318.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,284.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.68,318.25,
XR TOE OR TOES MIN 2 VWS,4280191,CDM,320,RC,,,outpatient,,,78,50.7,,52.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,70.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,62.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,58.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,66.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.88,74.1,
XR TMJ OPEN/CLOSED UNILATERAL LEFT,4280192,CDM,320,RC,,,outpatient,,,91.8,59.67,,61.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,82.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,73.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,78.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.57,87.21,
XR TMJ OPEN/CLOSED UNILATERAL RIGHT,4280193,CDM,320,RC,,,outpatient,,,91.8,59.67,,61.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,82.62,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,73.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.21,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,78.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.57,87.21,
XR SACROILIAC JOINTS LESS THEN 3 VIEWS,4280194,CDM,320,RC,,,outpatient,,,164.5,106.93,,110.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,131.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,44.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,139.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,98.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.04,156.28,
XR CLAVICLE COMPLETE RIGHT,4280195,CDM,320,RC,,,outpatient,,,88.5,57.53,,59.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,53.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.69,84.08,
XR SCAPULA COMPLETE RIGHT,4280196,CDM,320,RC,,,outpatient,,,145.5,94.58,,97.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,130.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,116.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,109.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,123.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,87.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.95,138.23,
XR SHOULDER 2 VIEWS RIGHT,4280197,CDM,320,RC,,,outpatient,,,632,410.8,,423.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,176.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,461.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,568.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,175.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,505.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,474,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,178.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,169.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,600.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,172.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,537.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,379.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,379.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,172.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,169.19,600.4,
XR HUMERUS 2 VIEWS RIGHT,4280198,CDM,320,RC,,,outpatient,,,526.5,342.23,,352.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,147.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,147.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,384.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,473.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,146.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,421.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,394.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,148.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,140.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,147.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,500.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,143.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,447.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,315.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,315.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,143.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.94,500.18,
XR ELBOW 3 VIEWS RIGHT,4280199,CDM,320,RC,,,outpatient,,,501,325.65,,335.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,140.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,365.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,450.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,139.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,400.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,375.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,141.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,134.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,475.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,136.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,425.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,300.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,300.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.12,475.95,
XR FOREARM 2 VIEWS RIGHT,4280200,CDM,320,RC,,,outpatient,,,262.5,170.63,,175.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,73.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,236.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,73.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,210,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,196.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,249.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,71.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,223.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,157.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.27,249.38,
XR WRIST 2 VIEWS RIGHT,4280201,CDM,320,RC,,,outpatient,,,101,65.65,,67.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.04,95.95,
XR WRIST 3 VIEWS RIGHT,4280202,CDM,320,RC,,,outpatient,,,155,100.75,,103.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,139.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,124,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,116.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,131.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.49,147.25,
XR HAND 2 VIEWS RIGHT,4280203,CDM,320,RC,,,outpatient,,,247,160.55,,165.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,69.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,69.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,180.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,222.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,68.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,197.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,185.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,66.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,69.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,209.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,66.12,234.65,
XR HAND MINIMUM 3 VIEWS LEFT,4280204,CDM,320,RC,,,outpatient,,,433,281.45,,290.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,389.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,120.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,346.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,324.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,122.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,411.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,368.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,115.91,411.35,
XR HAND MIN 3 VIEWS RIGHT,4280205,CDM,320,RC,,,outpatient,,,433,281.45,,290.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,389.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,120.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,346.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,324.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,122.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,411.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,368.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,115.91,411.35,
XR HIP UNILATERAL COMPLETE RIGHT 2-3view,4280206,CDM,320,RC,,,outpatient,,,205.5,133.58,,137.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,184.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,57.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,164.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,154.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,58.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,55.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,195.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,56.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,174.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,123.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.01,195.23,
XR FEMUR 2 VIEWS RIGHT,4280207,CDM,320,RC,,,outpatient,,,95.5,62.08,,63.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,71.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.57,90.73,
XR KNEE 3 VIEWS RIGHT,4280208,CDM,320,RC,,,outpatient,,,133.5,86.78,,89.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,120.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,100.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,80.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.74,126.83,
XR KNEE 4 OR MORE VIEWS RIGHT,4280209,CDM,320,RC,,,outpatient,,,215.5,140.08,,144.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,60.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,193.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,60,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,172.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,161.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,60.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,57.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,204.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,58.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,183.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,129.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.69,204.73,
XR TIBIA/FIBULA 2 VIEWS RIGHT,4280210,CDM,320,RC,,,outpatient,,,288.5,187.53,,193.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,259.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,230.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,274.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,245.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,173.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.23,274.08,
XR ANKLE 3 VIEWS RIGHT,4280211,CDM,320,RC,,,outpatient,,,532,345.8,,356.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,388.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,478.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,148.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,425.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,399,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,150.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,142.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,505.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,145.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,452.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,319.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,319.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,142.42,505.4,
XR FOOT COMPLETE 2 VIEWS LEFT,4280212,CDM,320,RC,,,outpatient,,,335,217.75,,224.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,244.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,301.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,93.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,268,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,251.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,318.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,284.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.68,318.25,
XR HEEL (CALCANEUS) 2 VIEWS RIGHT,4280214,CDM,320,RC,,,outpatient,,,264.5,171.93,,177.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,193.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,238.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,73.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,211.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,198.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,72.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,224.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,158.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,158.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.81,251.28,
US ABD > 2 ORGANS OR QUADRANTS,4280221,CDM,402,RC,,,outpatient,,,1003.5,652.28,,672.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,280.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,280.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,732.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,903.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,279.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,802.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,752.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,283.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,268.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,280.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,953.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,274.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,852.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,602.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,280.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,602.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,268.64,953.33,
US RETROPERITONEAL LIMITED,4280222,CDM,402,RC,,,outpatient,,,112,72.8,,75.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,100.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,89.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.98,106.4,
XR KNEE 1 OR 2 VIEWS LEFT,4280224,CDM,320,RC,,,outpatient,,,459.5,298.68,,307.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,128.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,128.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,335.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,413.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,127.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,367.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,344.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,129.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,123.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,128.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,436.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,125.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,390.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,275.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,275.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,123.01,436.53,
XR KNEE 1 OR 2 VIEWS RIGHT,4280225,CDM,320,RC,,,outpatient,,,459.5,298.68,,307.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,128.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,128.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,335.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,413.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,127.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,367.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,344.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,129.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,123.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,128.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,436.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,125.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,390.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,275.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,275.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,123.01,436.53,
US TRANSRECTAL,4280226,CDM,402,RC,,,outpatient,,,288,187.2,,192.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,259.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,230.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,273.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,244.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.1,273.6,
XR MANDIBLE PARTIAL LESS THAN 4 VIEWS,4280227,CDM,320,RC,,,outpatient,,,42.5,27.63,,28.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.38,40.38,
US PREGNANT UTERUS TRANSVAGINAL,4280228,CDM,402,RC,,,outpatient,,,288,187.2,,192.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,259.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,230.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,273.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,244.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.1,273.6,
XR ELBOW 2 VIEW RIGHT,4280266,CDM,320,RC,,,outpatient,,,278.5,181.03,,186.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,77.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,250.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,77.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,222.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,208.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,78.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,74.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,264.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,76.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,236.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,167.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.55,264.58,
XR ELBOW 2 VIEW LEFT,4280267,CDM,320,RC,,,outpatient,,,278.5,181.03,,186.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,77.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,250.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,77.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,222.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,208.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,78.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,74.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,264.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,76.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,236.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,167.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.55,264.58,
XR ANKLE 2 VIEWS LEFT,4280268,CDM,320,RC,,,outpatient,,,143,92.95,,95.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,128.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,114.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,107.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,121.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.28,135.85,
XR ANKLE 2 VIEWS RIGHT,4280269,CDM,320,RC,,,outpatient,,,143,92.95,,95.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,128.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,114.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,107.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,121.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.28,135.85,
XR CHILD NOSE TO RECTUM F B,4280270,CDM,320,RC,,,outpatient,,,57.5,37.38,,38.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.39,54.63,
XR ABDOMEN SINGLE ANT POST VIEW REPEAT,4280271,CDM,320,RC,,,outpatient,,,321,208.65,,215.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,89.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,89.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,288.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,89.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,256.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,240.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,90.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,85.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,89.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,304.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,87.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,272.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,192.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,192.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.93,304.95,
XR CHEST SINGLE VIEW FRONTAL REPEAT,4280272,CDM,324,RC,,,outpatient,,,112.5,73.13,,75.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,101.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,90,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.12,106.88,
MRA HEAD W/O CONTRAST,4310000,CDM,615,RC,,,outpatient,,,946,614.9,,633.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,253.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,690.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,851.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,263.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,756.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,709.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,267.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,253.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,898.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,258.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,804.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,567.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,567.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,253.24,898.7,
MRA NECK W/O CONTRAST,4310005,CDM,615,RC,,,outpatient,,,946,614.9,,633.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,253.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,690.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,851.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,263.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,756.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,709.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,267.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,253.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,898.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,258.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,804.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,567.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,567.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,253.24,898.7,
MRI BRAIN W/O CONTRAST,4320001,CDM,611,RC,,,outpatient,,,1135,737.75,,760.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,303.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,828.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1021.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,315.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,908,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,851.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,320.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,303.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1078.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,309.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,964.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,681,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,681,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,309.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,303.84,1078.25,
MRI BRAIN W/CONTRAST,4320002,CDM,611,RC,,,outpatient,,,358,232.7,,239.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,100.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,100.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,261.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,322.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,99.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,286.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,268.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,101.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,95.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,100.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,340.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,97.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,304.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,214.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,214.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.84,340.1,
MRI BRAIN W & W/O CONTRAST,4320003,CDM,611,RC,,,outpatient,,,1135,737.75,,760.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,303.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,828.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1021.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,315.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,908,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,851.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,320.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,303.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1078.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,309.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,964.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,681,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,681,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,309.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,303.84,1078.25,
MRI SPINE CERVICAL W/O CONTRAST,4320004,CDM,612,RC,,,outpatient,,,1260,819,,844.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,352.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,337.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,352.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,919.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1134,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,350.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1008,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,945,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,356.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,337.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,352.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1197,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,344.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1071,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,756,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,352.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,756,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,344.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,337.3,1197,
MRI SPINE CERVICAL W/CONTRAST,4320005,CDM,612,RC,,,outpatient,,,1087.5,706.88,,728.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,978.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,302.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,870,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,815.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,307.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1033.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,924.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,291.12,1033.13,
MRI SPINE CERVICAL W & W/O CONTRAST,4320006,CDM,612,RC,,,outpatient,,,1421.5,923.98,,952.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,398.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,380.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,398.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1037.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1279.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,395.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1137.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1066.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,402,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,380.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,398.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1350.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,388.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1208.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,852.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,398.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,852.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,380.54,1350.43,
MRI SPINE LUMBAR W/O CONTRAST,4320007,CDM,612,RC,,,outpatient,,,608,395.2,,407.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,170.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,162.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,170.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,443.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,547.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,169.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,486.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,456,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,171.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,162.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,170.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,577.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,166.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,516.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,364.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,364.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,166.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,162.76,577.6,
MRI SPINE LUMBAR W CONTRAST,4320008,CDM,612,RC,,,outpatient,,,1087.5,706.88,,728.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,978.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,302.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,870,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,815.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,307.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1033.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,924.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,291.12,1033.13,
MRI SPINE LUMBAR W & W/O CONTRAST,4320009,CDM,612,RC,,,outpatient,,,426.5,277.23,,285.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,311.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,383.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,118.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,341.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,319.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,120.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,114.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,362.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,255.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.17,405.18,
MRI SPINE THORACIC W/O CONTRAST,4320010,CDM,612,RC,,,outpatient,,,946,614.9,,633.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,253.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,690.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,851.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,263.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,756.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,709.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,267.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,253.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,898.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,258.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,804.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,567.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,567.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,253.24,898.7,
MRI SPINE THORACIC W CONTRAST,4320011,CDM,612,RC,,,outpatient,,,1087.5,706.88,,728.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,978.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,302.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,870,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,815.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,307.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1033.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,924.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,291.12,1033.13,
MRI SPINE THORACIC W & W/O CONTRAST,4320012,CDM,612,RC,,,outpatient,,,428,278.2,,286.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,312.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,385.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,119.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,342.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,321,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,121.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,114.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,406.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,363.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,256.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,256.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.58,406.6,
MRI PELVIS W/O CONTRAST,4320013,CDM,610,RC,,,outpatient,,,308,200.2,,206.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,86.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,86.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,224.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,277.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,85.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,246.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,231,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,87.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,82.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,86.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,292.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,84.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,261.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,184.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,184.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,82.45,292.6,
MRI PELVIS W/CONTRAST,4320014,CDM,610,RC,,,outpatient,,,1087.5,706.88,,728.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,978.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,302.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,870,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,815.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,307.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1033.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,924.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,291.12,1033.13,
MRI PELVIS W & W/O CONTRAST,4320015,CDM,610,RC,,,outpatient,,,652.5,424.13,,437.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,182.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,174.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,182.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,476.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,587.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,181.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,522,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,489.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,184.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,174.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,182.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,619.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,178.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,554.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,391.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,391.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,178.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,174.67,619.88,
MRI LOWER EXTREMITY JOINT W/O,4320016,CDM,610,RC,,,outpatient,,,1135,737.75,,760.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,303.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,828.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1021.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,315.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,908,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,851.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,320.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,303.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1078.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,309.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,964.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,681,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,317.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,681,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,309.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,303.84,1078.25,
MRI LOWER EXTREMITY JOINT W/CONTRAST,4320017,CDM,610,RC,,,outpatient,,,1675,1088.75,,1122.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,469,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,448.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,469,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1222.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1507.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,466.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1340,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1256.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,473.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,448.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,469,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1591.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,457.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1423.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1005,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,469,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1005,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,457.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,448.4,1591.25,
MRI LOWER EXTREMITY JOINT W & W/O CONT.,4320018,CDM,610,RC,,,outpatient,,,1087.5,706.88,,728.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,978.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,302.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,870,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,815.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,307.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1033.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,924.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,291.12,1033.13,
MRI ABDOMEN W/O CONTRAST,4320019,CDM,610,RC,,,outpatient,,,1050,682.5,,703.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,294,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,766.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,945,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,292.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,840,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,787.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,296.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,281.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,997.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,286.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,892.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,281.09,997.5,
MRI ABDOMEN W/CONTRAST,4320020,CDM,610,RC,,,outpatient,,,1087.5,706.88,,728.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,978.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,302.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,870,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,815.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,307.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1033.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,924.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,291.12,1033.13,
MRI ABDOMEN W & W/O CONTRAST,4320021,CDM,610,RC,,,outpatient,,,1087.5,706.88,,728.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,978.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,302.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,870,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,815.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,307.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1033.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,924.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,291.12,1033.13,
MRI UPPER EXTREMITY JOINT W/O CONTRAST,4320022,CDM,610,RC,,,outpatient,,,1259.5,818.68,,843.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,352.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,337.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,352.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,919.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1133.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,350.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1007.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,944.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,356.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,337.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,352.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1196.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,343.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1070.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,755.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,352.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,755.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,343.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,337.17,1196.53,
MRI UPPER EXTREMITY JOINT W/CONTRAST,4320023,CDM,610,RC,,,outpatient,,,1675,1088.75,,1122.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,469,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,448.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,469,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1222.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1507.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,466.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1340,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1256.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,473.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,448.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,469,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1591.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,457.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1423.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1005,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,469,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1005,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,457.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,448.4,1591.25,
MRI UPPER EXTREMITY JOINT  W & W/O CONT,4320024,CDM,610,RC,,,outpatient,,,1087.5,706.88,,728.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,978.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,302.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,870,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,815.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,307.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,291.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1033.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,924.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,304.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,652.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,296.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,291.12,1033.13,
MRI UPPER EXTREMITY other than joint w/o,4320025,CDM,610,RC,,,outpatient,,,946,614.9,,633.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,253.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,690.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,851.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,263.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,756.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,709.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,267.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,253.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,898.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,258.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,804.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,567.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,567.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,253.24,898.7,
MRI LOWER EXTREMITY other than joint w/o,4320026,CDM,610,RC,,,outpatient,,,898.5,584.03,,602,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,251.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,240.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,251.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,655.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,808.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,250.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,718.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,673.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,254.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,240.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,251.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,853.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,245.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,763.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,539.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,251.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,539.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,245.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.53,853.58,
CT HEAD OR BRAIN  W/O CONTRAST,4350001,CDM,351,RC,,,outpatient,,,216.5,140.73,,145.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,60.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,158.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,194.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,60.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,173.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,162.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,61.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,57.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,60.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,205.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,59.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,184.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.96,205.68,
CT HEAD OR BRAIN W & W/O CONTRAST,4350003,CDM,351,RC,,,outpatient,,,341,221.65,,228.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,95.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,95.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,248.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,306.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,94.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,272.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,255.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,96.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,91.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,95.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,323.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,93.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,289.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,91.29,323.95,
CT THORAX W/O CONTRAST,4350004,CDM,359,RC,,,outpatient,,,297,193.05,,198.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,216.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,267.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,82.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,222.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,79.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,282.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,252.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.51,282.15,
CT THORAX W/CONTRAST,4350005,CDM,352,RC,,,outpatient,,,812.5,528.13,,544.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,227.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,217.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,227.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,593.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,731.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,226.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,650,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,609.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,229.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,217.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,227.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,771.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,221.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,690.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,487.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,227.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,487.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,217.51,771.88,
CT THORAX W & W/O CONTRAST,4350006,CDM,359,RC,,,outpatient,,,517,336.05,,346.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,377.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,465.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,143.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,413.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,387.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,146.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,138.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,491.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,141.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,439.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,310.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,310.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,138.4,491.15,
CT CERVICAL SPINE W/O CONTRAST,4350007,CDM,352,RC,,,outpatient,,,579,376.35,,387.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,162.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,155,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,162.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,422.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,521.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,161.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,463.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,434.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,163.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,155,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,162.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,550.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,158.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,492.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,347.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,347.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,158.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155,550.05,
CT CERVICAL SPINE W/CONTRAST,4350008,CDM,359,RC,,,outpatient,,,227,147.55,,152.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,63.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,165.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,204.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,63.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,181.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,170.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,64.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,215.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,192.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,136.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,136.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.77,215.65,
CT THORACIC SPINE W/O CONTRAST,4350009,CDM,352,RC,,,outpatient,,,864.5,561.93,,579.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,242.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,231.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,242.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,631.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,778.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,240.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,691.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,648.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,244.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,231.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,242.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,821.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,236.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,734.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,518.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,518.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,236.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,231.43,821.28,
CT THORACIC SPINE W/CONTRAST,4350010,CDM,359,RC,,,outpatient,,,406,263.9,,272.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,113.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,113.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,296.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,365.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,113.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,324.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,304.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,114.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,108.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,113.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,385.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,110.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,345.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,243.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,108.69,385.7,
CT LUMBAR SPINE W/O CONTRAST,4350011,CDM,352,RC,,,outpatient,,,579,376.35,,387.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,162.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,155,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,162.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,422.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,521.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,161.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,463.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,434.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,163.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,155,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,162.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,550.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,158.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,492.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,347.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,347.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,158.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155,550.05,
CT LUMBAR SPINE W/CONTRAST,4350012,CDM,359,RC,,,outpatient,,,391.5,254.48,,262.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,285.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,352.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,108.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,313.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,293.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,110.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,104.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,371.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,106.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,332.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,234.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.8,371.93,
CT PELVIS W/O CONTRAST,4350013,CDM,359,RC,,,outpatient,,,341,221.65,,228.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,95.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,95.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,248.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,306.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,94.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,272.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,255.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,96.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,91.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,95.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,323.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,93.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,289.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,91.29,323.95,
CT PELVIS W/CONTRAST,4350014,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT PELVIS W & W/O CONTRAST,4350015,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT UPPER EXTREMITY W/O CONTRAST,4350016,CDM,359,RC,,,outpatient,,,207,134.55,,138.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,57.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,151.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,186.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,57.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,165.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,155.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,58.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,55.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,196.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,56.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,175.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.41,196.65,
CT UPPER EXTREMITY W/CONTRAST,4350017,CDM,359,RC,,,outpatient,,,337.5,219.38,,226.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,94.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,246.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,303.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,93.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,270,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,253.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,95.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,90.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,320.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,92.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,286.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,202.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,202.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,90.35,320.63,
CT UPPER EXTREMITY W & W/O CONTRA,4350018,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT LOWER EXTREMITY W/O CONTRAST,4350019,CDM,359,RC,,,outpatient,,,120.5,78.33,,80.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,108.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.26,114.48,
CT LOWER EXTREMITY W/CONTRAST,4350020,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT LOWER EXTREMITY W & W/O CONT,4350021,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT ABD W/O CONTRAST,4350022,CDM,352,RC,,,outpatient,,,419.5,272.68,,281.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,306.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,377.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,335.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,314.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,398.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,356.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.3,398.53,
CT ABD W/CONTRAST,4350023,CDM,359,RC,,,outpatient,,,686,445.9,,459.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,192.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,183.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,192.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,500.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,617.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,190.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,548.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,514.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,194,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,183.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,192.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,651.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,187.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,583.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,411.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,411.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,187.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,183.64,651.7,
CT ABD W & W/O CONTRAST,4350024,CDM,359,RC,,,outpatient,,,323,209.95,,216.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,90.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,90.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,235.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,290.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,89.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,258.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,242.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,91.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,86.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,90.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,306.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,88.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,274.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,193.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,193.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.47,306.85,
CT SOFT TISSUE NECK W/O CONTRAST,4350027,CDM,359,RC,,,outpatient,,,192.5,125.13,,128.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,53.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,140.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,173.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,53.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,154,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,144.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,54.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,51.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,182.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,52.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,51.53,182.88,
CT SOFT TISSUE NECK W/CONTRAST,4350028,CDM,350,RC,,,outpatient,,,1477,960.05,,989.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,413.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,395.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,413.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1078.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1329.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,411.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1181.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1107.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,417.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,395.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,413.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1403.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,403.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1255.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,886.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,413.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,886.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,403.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,395.39,1403.15,
CT ORBIT W/O CONTRAST,4350029,CDM,359,RC,,,outpatient,,,372,241.8,,249.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,104.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,104.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,271.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,334.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,103.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,297.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,279,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,105.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,99.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,104.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,353.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,101.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,316.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,223.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,223.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,99.58,353.4,
CT MAXILLOFACIAL W/CONTRAST,4350034,CDM,359,RC,,,outpatient,,,294.5,191.43,,197.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,82.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,214.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,265.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,81.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,235.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,220.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,78.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,279.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,80.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,250.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,176.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,176.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,78.84,279.78,
CT SOFT TISSUE NECK W & W/O CONTRAST,4350035,CDM,359,RC,,,outpatient,,,517,336.05,,346.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,377.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,465.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,143.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,413.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,387.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,146.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,138.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,491.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,141.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,439.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,310.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,310.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,138.4,491.15,
CT MAXILLOFACIAL W/O CONTRAST,4350036,CDM,350,RC,,,outpatient,,,477.5,310.38,,319.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,348.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,429.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,132.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,382,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,358.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,135.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,127.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,453.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,130.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,405.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,286.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,127.83,453.63,
CT ORBIT W & W/O CONTRAST,4350038,CDM,359,RC,,,outpatient,,,286.5,186.23,,191.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,209.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,257.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,79.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,229.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,214.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,76.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,272.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,243.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,171.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,171.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.7,272.18,
CT ORBIT W/CONTRAST,4350039,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT MAXILLOFACIAL W & W/O CONTRAST,4350040,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT CERVICAL SPINE W & W/O CONTRAST,4350041,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT THORACIC SPINE W & W/O CONTRAST,4350042,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT LUMBAR SPINE W & W/O CONTRAST,4350043,CDM,359,RC,,,outpatient,,,676.5,439.73,,453.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,493.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,608.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,188.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,541.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,507.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,191.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,181.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,405.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.1,642.68,
CT ABD & PELVIS w/ORAL CONTRAST,4350051,CDM,352,RC,,,outpatient,,,1670.5,1085.83,,1119.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,467.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,447.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,467.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1219.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1503.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,465.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1336.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1252.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,472.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,447.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,467.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1586.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,456.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1419.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1002.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,467.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1002.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,447.19,1586.98,
CT ABD & PELVIS WITH CONTRAST,4350052,CDM,350,RC,,,outpatient,,,1670.5,1085.83,,1119.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,467.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,447.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,467.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1219.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1503.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,465.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1336.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1252.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,472.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,447.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,467.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1586.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,456.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1419.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1002.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,467.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1002.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,447.19,1586.98,
CT ABD / PELVIS W/ W/O CONTRAST MATE,4350053,CDM,350,RC,,,outpatient,,,425.5,276.58,,285.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,310.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,382.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,118.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,340.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,319.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,120.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,113.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,404.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,361.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.91,404.23,
CT ANGIOGRAPHY CHEST PE with CONTRAST,4350054,CDM,350,RC,,,outpatient,,,565.5,367.58,,378.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,158.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,151.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,158.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,412.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,508.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,157.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,452.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,424.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,159.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,151.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,158.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,537.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,154.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,480.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,339.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,158.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,339.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,154.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,151.38,537.23,
CT ABD & PELVIS without ORAL CONTRAST,4350055,CDM,352,RC,,,outpatient,,,1010.5,656.83,,677.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,282.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,270.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,282.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,737.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,909.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,281.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,808.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,757.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,285.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,270.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,282.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,959.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,275.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,858.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,606.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,606.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,275.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,270.51,959.98,
CT ANGIOGRAPHY HEAD,4350056,CDM,351,RC,,,outpatient,,,806.96,524.52,,540.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,225.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,216.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,225.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,589.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,726.26,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,224.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,645.57,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,605.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,228.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,216.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,225.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,766.61,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,220.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,685.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,484.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225.95,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,484.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,220.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,216.02,766.61,
CT UNLISTED,4359999,CDM,359,RC,,,outpatient,,,517,336.05,,346.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,377.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,465.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,143.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,413.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,387.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,146.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,138.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,491.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,141.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,439.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,310.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,310.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,138.4,491.15,
CBC W/AUTO 3 part DIFF & PLT,4360000,CDM,300,RC,,,outpatient,,,15.5,10.08,,10.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.15,14.73,
CBC W/AUTO 5 part DIFF & PLT,4360001,CDM,300,RC,,,outpatient,,,15.5,10.08,,10.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.15,14.73,
"WHITE BLOOD CELL (WBC), AUTOMATED",4360002,CDM,300,RC,,,outpatient,,,18.5,12.03,,12.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.95,17.58,
HEMOGLOBIN,4360004,CDM,300,RC,,,outpatient,,,5.5,3.58,,3.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,5.23,
HEMATOCRIT,4360005,CDM,300,RC,85014,HCPCS,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.98,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.26,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.1,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.98,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.04,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.04,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,2.24,7.6,
CBC  AUTOMATED W/O DIFF,4360006,CDM,300,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
SICKLE CELL SCREEN,4360007,CDM,300,RC,,,outpatient,,,7,4.55,,4.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.87,6.65,
CULTURE AEROBIC ROUTINE,4360010,CDM,300,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
PLATELET; AUTOMATED COUNT,4360011,CDM,300,RC,,,outpatient,,,5.5,3.58,,3.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,5.23,
"RETICULOCYTE , AUTOMATED",4360012,CDM,300,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
"SEDIMENTATION RATE,ERYTHROCYTE;NON AUTO",4360013,CDM,300,RC,,,outpatient,,,8.5,5.53,,5.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.28,8.08,
PROTHROMBIN TIME,4360014,CDM,300,RC,,,outpatient,,,8.5,5.53,,5.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.28,8.08,
PARTIAL THROMBOPLASTIN TIME (PTT),4360015,CDM,300,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
SYPHILIS TEST; RPR W/ FTA-ABS REFLEX,4360016,CDM,300,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
KOH PREP,4360017,CDM,300,RC,,,outpatient,,,18.6,12.09,,12.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.81,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.98,17.67,
URINALYSIS (UA SCREEN) AUTO W/MICRO,4360018,CDM,300,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
"SERUM PREGNANCY TEST, QUALITATIVE",4360019,CDM,300,RC,,,outpatient,,,22.5,14.63,,15.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.02,21.38,
"URINE PREGNANCY TEST, QUALITATIVE",4360020,CDM,300,RC,,,outpatient,,,142,92.3,,95.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,127.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,113.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,106.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,120.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.01,134.9,
GLUCOSE TOLERANCE TEST (GTT) 3 SPECIMENS,4360021,CDM,300,RC,,,outpatient,,,59.5,38.68,,39.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,53.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.93,56.53,
GLUCOSE TOLERANCE TEST ADDL MORE 3 SPECS,4360022,CDM,300,RC,,,outpatient,,,29,18.85,,19.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.76,27.55,
"CK; CREATINE KINASE, TOTAL, SERUM",4360023,CDM,300,RC,,,outpatient,,,15.5,10.08,,10.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.15,14.73,
LACTATE DEHYDROGENASE;LDH,4360024,CDM,300,RC,,,outpatient,,,7.5,4.88,,5.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.01,7.13,
AST; ASPARATATE AMINO (SGOT),4360025,CDM,300,RC,,,outpatient,,,68,44.2,,45.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.2,64.6,
ALT; ALANINE AMINO (SGPT),4360027,CDM,300,RC,,,outpatient,,,61.5,39.98,,41.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.46,58.43,
ALKALINE PHOSPHATASE,4360028,CDM,300,RC,84075,HCPCS,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.35,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.11,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.6,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.35,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.48,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,1.82,7.11,
AMYLASE,4360029,CDM,300,RC,82150,HCPCS,outpatient,,,61.5,39.98,,41.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.15,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.91,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,55.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.48,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,49.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.15,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.31,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,52.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,8.15,58.43,
ACID PHOSPHATASE TOTAL,4360030,CDM,300,RC,,,outpatient,,,54.5,35.43,,36.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.59,51.78,
BILIRUBIN; TOTAL,4360031,CDM,300,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
BILIRUBIN; DIRECT,4360032,CDM,300,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
BRAIN NATRIURETIC PEPTIDE,4360033,CDM,300,RC,,,outpatient,,,79,51.35,,52.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,71.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,63.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,59.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.15,75.05,
"GLUCOSE,BLOOD,REAGENT STRIP",4360034,CDM,300,RC,,,outpatient,,,10.5,6.83,,7.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.81,9.98,
GLUCOSE; POST GLUCOSE DOSE,4360035,CDM,300,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
UREA NITROGEN;QUANT (BUN) SERUM,4360036,CDM,300,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
CREATININE; SERUM,4360037,CDM,300,RC,,,outpatient,,,15.5,10.08,,10.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.15,14.73,
"CHOLESTEROL,TOTAL;SERUM",4360038,CDM,300,RC,,,outpatient,,,32,20.8,,21.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,28.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,25.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.57,30.4,
"URIC ACID, SERUM",4360039,CDM,300,RC,,,outpatient,,,9,5.85,,6.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.41,8.55,
"SODIUM, SERUM",4360040,CDM,300,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
POTASSIUM; SERUM,4360041,CDM,300,RC,,,outpatient,,,14.5,9.43,,9.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.88,13.78,
CHLORIDE; SERUM,4360042,CDM,300,RC,,,outpatient,,,34,22.1,,22.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,32.3,
"CARBON DIOXIDE (BICARBONATE), TOTAL",4360043,CDM,300,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
"PROTEIN,TOTAL, SERUM",4360044,CDM,300,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
ALBUMIN; SERUM,4360045,CDM,300,RC,,,outpatient,,,7.5,4.88,,5.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.01,7.13,
CALCIUM; SERUM,4360046,CDM,300,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
PHOSPHORUS SERUM,4360047,CDM,300,RC,,,outpatient,,,4.5,2.93,,3.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.2,4.28,
ELECTROLYTE PANEL,4360048,CDM,300,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
COMPREHENSIVE METABOLIC PANEL,4360050,CDM,300,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
"HEPARIN ANTI-Xa, LMWH",4360051,CDM,300,RC,,,outpatient,,,94,61.1,,62.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,84.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,75.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,70.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.16,89.3,
"MONONUCLEOSIS SCREEN, QUALITATIVE",4360055,CDM,300,RC,,,outpatient,,,16,10.4,,10.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.28,15.2,
RHEUMATOID FACTOR TEST,4360056,CDM,300,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
ANA REFLEX TO AUTOIMMUNE PANEL,4360061,CDM,300,RC,,,outpatient,,,33.5,21.78,,22.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.97,31.83,
"BODY FLUIDS, CELL COUNT",4360062,CDM,300,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
CHLORIDE; BODY FLUID,4360065,CDM,300,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
"STOOL CULTURE:S,S,E TOXIN1,2,CAMPY",4360066,CDM,300,RC,,,outpatient,,,28.5,18.53,,19.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.63,27.08,
GRAM STAIN,4360067,CDM,300,RC,,,outpatient,,,5.5,3.58,,3.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,5.23,
"NEISSERIA GONORRHOEAE, AMPLIFIED URINE",4360068,CDM,300,RC,,,outpatient,,,81,52.65,,54.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.68,76.95,
"CULTURE,TUBERCLE OR ACID-FAST BACILLI",4360069,CDM,300,RC,,,outpatient,,,52.5,34.13,,35.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.05,49.88,
CULTURE BLOOD SET #1,4360070,CDM,300,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
CULTURE ANAEROBE,4360071,CDM,300,RC,,,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.21,11.4,
"CULTURE FUNGAL, NON-BLOOD OR SKIN",4360072,CDM,300,RC,,,outpatient,,,61.5,39.98,,41.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.46,58.43,
OVA & PARASITES MICROSCOPIC,4360073,CDM,300,RC,,,outpatient,,,26.5,17.23,,17.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.09,25.18,
"OCCULT BLOOD,FECES1-3",4360075,CDM,300,RC,,,outpatient,,,8.5,5.53,,5.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.28,8.08,
HERPES CULTURE,4360076,CDM,300,RC,,,outpatient,,,326.5,212.23,,218.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,91.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,91.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,238.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,293.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,90.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,261.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,244.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,92.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,87.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,91.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,310.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,89.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,277.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,195.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,195.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,87.4,310.18,
"RED BLOOD CELLS, LEUKOCYTES REDUCED @ UN",4360078,CDM,385,RC,,,outpatient,,,416.5,270.73,,279.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,116.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,116.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,304.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,374.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,115.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,333.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,312.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,117.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,111.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,116.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,395.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,113.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,354.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.5,395.68,
RED BLOOD CELLS @ UNIT,4360079,CDM,381,RC,,,outpatient,,,615.5,400.08,,412.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,172.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,172.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,449.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,553.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,171.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,492.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,461.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,174.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,164.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,172.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,584.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,168.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,523.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,369.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,172.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,369.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,164.77,584.73,
"ABO, BLOOD TYPE",4360081,CDM,300,RC,,,outpatient,,,56,36.4,,37.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.99,53.2,
"GABAPENTIN,SERUM",4360082,CDM,300,RC,,,outpatient,,,52.2,33.93,,34.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.98,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.59,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.37,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.97,49.59,
"IMMUNOCHEMICAL FOBT, STOOL",4360084,CDM,300,RC,,,outpatient,,,114.5,74.43,,76.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,32.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,103.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,91.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,85.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,97.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,68.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.65,108.78,
COLD AGGLUTININS; SCREEN,4360100,CDM,300,RC,,,outpatient,,,48,31.2,,32.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.85,45.6,
LACTATE DEHYDROGENASE (LDH) ISOENZYMES,4360102,CDM,300,RC,,,outpatient,,,84,54.6,,56.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,67.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.49,79.8,
"PHENYTOIN; TOTAL, SERUM",4360103,CDM,300,RC,,,outpatient,,,40,26,,26.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,38,
DRUG TEST(S) 1-7 DRUG CLASS(ES) (local),4360104,CDM,300,RC,,,outpatient,,,57,37.05,,38.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.26,54.15,
VITAMIN B12,4360106,CDM,300,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
IRON,4360108,CDM,300,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
IRON BINDING CAPACITY,4360109,CDM,300,RC,,,outpatient,,,17.5,11.38,,11.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,16.63,
LITHIUM,4360114,CDM,300,RC,80178,HCPCS,outpatient,,,8.5,5.53,,5.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.32,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.09,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,7.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.65,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,6.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.32,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.49,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,7.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.49,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,2.38,9.09,
MAGNESIUM SERUM,4360115,CDM,300,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
PROTEIN ELECTROPHORESIS; SERUM,4360117,CDM,300,RC,,,outpatient,,,13.5,8.78,,9.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.61,12.83,
RUBELLA  AB IGG,4360118,CDM,300,RC,,,outpatient,,,29,18.85,,19.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.76,27.55,
T3 TOTAL,4360120,CDM,300,RC,,,outpatient,,,165.5,107.58,,110.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,46.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,132.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,124.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,99.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.3,157.23,
T-4 TOTAL (THYROXINE),4360121,CDM,300,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
T3 UPTAKE,4360122,CDM,300,RC,84479,HCPCS,outpatient,,,27.6,17.94,,18.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.14,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,7.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.89,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,24.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.47,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,22.08,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.7,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.14,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,7.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.22,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.3,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,23.46,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.3,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,7.73,26.22,
TRIGLYCERIDES,4360123,CDM,300,RC,84478,HCPCS,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.35,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.9,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.6,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.35,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.48,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,4.2,14.25,
ANTIHUMAN GLOBULIN TEST (COOMBS)DIRECT,4360124,CDM,300,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
ANTIHUMAN GLOBULIN TEST (COOMBS); INDIRE,4360125,CDM,300,RC,,,outpatient,,,26.5,17.23,,17.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.09,25.18,
"ANTIHUMAN GLOBULIN TEST; INDIR, TITER",4360126,CDM,300,RC,,,outpatient,,,133,86.45,,89.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,119.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.6,126.35,
SEMEN ANALYSIS; MOTILITY AND COUNT,4360129,CDM,300,RC,,,outpatient,,,62.5,40.63,,41.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,56.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.73,59.38,
DIGOXIN,4360130,CDM,300,RC,,,outpatient,,,40,26,,26.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.71,38,
PPD (TB); INTRADERMAL,4360133,CDM,300,RC,,,outpatient,,,17.5,11.38,,11.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,16.63,
ALCOHOL,4360134,CDM,300,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
CKMB; CREATINE KINASE MB,4360135,CDM,300,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
DNA DOUBLE STRANDED ANTIBODY,4360136,CDM,300,RC,,,outpatient,,,41,26.65,,27.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.98,38.95,
FIBRINOGEN,4360138,CDM,300,RC,85384,HCPCS,outpatient,,,111.93,72.75,,74.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.68,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,31.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.68,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,100.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.11,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,89.54,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,83.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.68,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,31.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.89,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,95.14,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,10.68,106.33,
LIPASE,4360139,CDM,300,RC,83690,HCPCS,outpatient,,,64.5,41.93,,43.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.66,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.47,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,58.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.01,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,51.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.66,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.83,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,54.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.83,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,8.66,61.28,
THEOPHYLLIN,4360142,CDM,300,RC,,,outpatient,,,101,65.65,,67.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.04,95.95,
MUMPS VIRUS IGG,4360144,CDM,300,RC,,,outpatient,,,94,61.1,,62.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,84.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,75.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,70.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.16,89.3,
T PALLIDUM AB,4360146,CDM,300,RC,,,outpatient,,,16.5,10.73,,11.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.42,15.68,
THYROID STIMULATING HORMONE (TSH),4360147,CDM,300,RC,,,outpatient,,,34,22.1,,22.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,32.3,
HISTOPLASMA TOTAL AB;SERUM,4360148,CDM,300,RC,,,outpatient,,,90,58.5,,60.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.09,85.5,
PLASMA FROZEN W/IN 24 HRS,4360150,CDM,383,RC,,,outpatient,,,246,159.9,,164.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,179.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,221.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,68.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,196.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,184.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,233.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,209.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.85,233.7,
"PORPHOBILINOGEN,URINE 24HR OR RANDOM",4360151,CDM,300,RC,,,outpatient,,,61.5,39.98,,41.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.46,58.43,
"PORPHYRINS,URINE 24 HR OR RANDOM",4360152,CDM,300,RC,,,outpatient,,,106.5,69.23,,71.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,95.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,85.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,79.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,90.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.51,101.18,
"RH, BLOOD TYPE",4360153,CDM,300,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
PARATHYROID HORMONE INTACT,4360155,CDM,300,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
RENIN ACTIVITY,4360156,CDM,300,RC,,,outpatient,,,95,61.75,,63.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,71.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.43,90.25,
VANILLYLMANDELIC ACID (VMA);URINE 24 HR,4360159,CDM,300,RC,,,outpatient,,,112.5,73.13,,75.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,101.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,90,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.12,106.88,
"METANEPHRINES FRACTIONATED,24 HR URINE",4360160,CDM,300,RC,,,outpatient,,,73,47.45,,48.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,65.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,58.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.54,69.35,
CARCINOEMBRYONIC ANTIGEN (CEA),4360161,CDM,300,RC,,,outpatient,,,57,37.05,,38.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.26,54.15,
FECAL FAT; QUALITATIVE,4360162,CDM,300,RC,,,outpatient,,,37,24.05,,24.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.9,35.15,
GLUCOSE-6-PHOSPHATE DEHYDROGENASE QUANT,4360163,CDM,300,RC,,,outpatient,,,34.5,22.43,,23.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.24,32.78,
ACETAMINOPHEN,4360164,CDM,300,RC,,,outpatient,,,5.5,3.58,,3.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,5.23,
THYROGLOBULIN ANTIBODY,4360165,CDM,300,RC,,,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.35,19,
"GLUTAMYLTRANSFERASE,GAMMA (GGT)",4360167,CDM,300,RC,,,outpatient,,,31,20.15,,20.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,23.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.3,29.45,
DIRECT LDL CHOLESTEROL,4360169,CDM,300,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
HDL CHOLESTEROL,4360170,CDM,300,RC,,,outpatient,,,59.5,38.68,,39.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,53.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.93,56.53,
CREATININE URINE RANDOM,4360172,CDM,300,RC,,,outpatient,,,10.5,6.83,,7.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.81,9.98,
ALDOLASE,4360173,CDM,300,RC,82085,HCPCS,outpatient,,,12,7.8,,8.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.2,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.34,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,10.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.69,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,9.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.2,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.44,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,10.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.44,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,3.36,13.34,
PROLACTIN,4360175,CDM,300,RC,84146,HCPCS,outpatient,,,195.5,127.08,,130.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.37,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.64,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,175.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.34,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,156.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,146.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.37,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,185.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.86,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,166.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,117.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.86,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,24.37,185.73,
HERPES VIRUS TYPE 2 IGG SERUM,4360176,CDM,300,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
ACID FAST AND/OR FLURESCENT STAIN,4360178,CDM,300,RC,,,outpatient,,,39,25.35,,26.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.44,37.05,
HUMAN GROWTH HORMONE,4360179,CDM,300,RC,,,outpatient,,,102,66.3,,68.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,91.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,81.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.31,96.9,
IMMUNOFIXATION ELECTROPHORESIS URINE,4360180,CDM,300,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
CARBAMAZEPINE (TEGRETOL),4360182,CDM,300,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
GENTAMYCIN TROUGH,4360184,CDM,300,RC,,,outpatient,,,118.5,77.03,,79.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,106.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,94.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,88.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,100.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.72,112.58,
LIPID PANEL,4360185,CDM,300,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
OSMOLALITY; URINE,4360186,CDM,300,RC,,,outpatient,,,20.5,13.33,,13.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.49,19.48,
TOBRAMYCIN PEAK,4360188,CDM,300,RC,80200,HCPCS,outpatient,,,108.5,70.53,,72.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.84,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,30.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.58,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,97.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.59,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,86.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,81.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.84,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,30.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.22,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,92.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,65.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.22,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,18.84,103.08,
TOBRAMYCIN TROUGH,4360189,CDM,300,RC,80200,HCPCS,outpatient,,,108.5,70.53,,72.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.84,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,30.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.58,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,97.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.59,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,86.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,81.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.84,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,30.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.22,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,92.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,65.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.22,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,18.84,103.08,
PHENOBARBITAL,4360192,CDM,300,RC,80184,HCPCS,outpatient,,,19,12.35,,12.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.41,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.74,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,17.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.99,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,15.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.41,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.7,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,16.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,5.32,18.05,
PROINSULIN,4360195,CDM,300,RC,84206,HCPCS,outpatient,,,127.5,82.88,,85.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.4,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,35.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.49,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,114.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.3,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,102,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,95.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.4,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,35.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.85,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,108.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.85,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,22.4,121.13,
QUINIDINE,4360197,CDM,300,RC,80194,HCPCS,outpatient,,,104.5,67.93,,70.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.35,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,29.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.07,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,94.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.08,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,83.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,78.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.35,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,29.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.72,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,88.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,18.35,99.28,
COPPER SERUM/PLASMA,4360201,CDM,300,RC,,,outpatient,,,15.5,10.08,,10.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.15,14.73,
CERULOPLASMIN,4360202,CDM,300,RC,82390,HCPCS,outpatient,,,46.8,30.42,,31.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,13.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.76,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,42.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.05,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,37.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,35.1,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.51,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,13.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.78,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,39.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.78,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,13.1,44.46,
"AMMONIA, PLASMA",4360203,CDM,300,RC,,,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.35,19,
ALPHA-1-ANTITRYPSIN TOTAL,4360204,CDM,300,RC,,,outpatient,,,44,28.6,,29.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.78,41.8,
"HYDROXYPROGESTERONE, 17",4360205,CDM,300,RC,,,outpatient,,,195,126.75,,130.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,54.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,175.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,156,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,146.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,185.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,165.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.2,185.25,
"KETOSTEROIDS, 17-(17-KS); URINE",4360206,CDM,300,RC,,,outpatient,,,90,58.5,,60.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.09,85.5,
FOLLICLE STIMULATING HORMONE (FSH),4360207,CDM,300,RC,,,outpatient,,,210.5,136.83,,141.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,58.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,153.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,189.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,58.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,168.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,157.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,59.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,56.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,57.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,178.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,126.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.35,199.98,
LUTEINIZING HORMONE (LH),4360208,CDM,300,RC,,,outpatient,,,225,146.25,,150.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,180,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,191.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.23,213.75,
THYROXINE BINDING GLOBULINS (TBG),4360210,CDM,300,RC,,,outpatient,,,50.4,32.76,,33.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.49,47.88,
ANGIOTENSIN 1-CONVERTING ENZYME (ACE),4360215,CDM,300,RC,,,outpatient,,,18.5,12.03,,12.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.95,17.58,
LYSOZYME,4360216,CDM,300,RC,85549,HCPCS,outpatient,,,135,87.75,,90.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.59,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,37.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.78,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,121.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.53,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,108,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,101.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,38.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.59,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,37.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.06,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,114.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,23.59,128.25,
ALPHA-FETOPROTEIN (AFP) TUMOR MARKER,4360218,CDM,300,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
"STREP SCREEN,GROUP A",4360220,CDM,300,RC,,,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.83,31.35,
ZINC SERUM/PLASMA,4360222,CDM,300,RC,,,outpatient,,,14,9.1,,9.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.75,13.3,
LEUKOCYTE ALKALINE PHOSPHATASE,4360223,CDM,300,RC,85540,HCPCS,outpatient,,,44,28.6,,29.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.31,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,39.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.9,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,35.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.6,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.75,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,37.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.75,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,7.6,41.8,
FERRITIN,4360224,CDM,300,RC,,,outpatient,,,27.5,17.88,,18.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.36,26.13,
CRYOGLOBULIN QUALITATIVE,4360230,CDM,300,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
HEMOGLOBIN; GLYCOSYLATED (A1C),4360234,CDM,300,RC,,,outpatient,,,19.5,12.68,,13.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.22,18.53,
SALICYLATE,4360236,CDM,300,RC,,,outpatient,,,5.5,3.58,,3.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,5.23,
TOXOPLASMA IgM ANTIBODIES,4360239,CDM,300,RC,,,outpatient,,,103.5,67.28,,69.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,93.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,82.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,77.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,87.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,62.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.71,98.33,
"IMMUNOGLOBULIN PANEL IGA,IGG,IGM",4360240,CDM,300,RC,,,outpatient,,,11.5,7.48,,7.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.08,10.93,
HEPATIC FUNCTION PANEL,4360241,CDM,300,RC,,,outpatient,,,24.5,15.93,,16.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.56,23.28,
HEMOGLOBIN ELECTROPHORESIS,4360244,CDM,300,RC,,,outpatient,,,16.5,10.73,,11.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.42,15.68,
CORTISOL FREE SERUM,4360245,CDM,300,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
INSULIN; TOTAL,4360248,CDM,300,RC,,,outpatient,,,144.5,93.93,,96.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,130.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,115.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,108.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,137.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,122.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,86.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.68,137.28,
"ASPERGILLUS IGG, IGM, IGA ANTIBODIES",4360249,CDM,300,RC,,,outpatient,,,109.5,71.18,,73.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,98.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,87.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,65.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.31,104.03,
C-REACTIVE PROTEIN,4360251,CDM,300,RC,,,outpatient,,,10.5,6.83,,7.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.81,9.98,
"HEPATITIS B CORE ANTIBODIES, TOTAL",4360253,CDM,300,RC,,,outpatient,,,22,14.3,,14.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.89,20.9,
HEPATITIS B SURFACE ANTIGEN (HBsAg),4360255,CDM,300,RC,,,outpatient,,,63.5,41.28,,42.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,60.33,
HAPTOGLOBIN,4360256,CDM,300,RC,83010,HCPCS,outpatient,,,16.8,10.92,,11.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.69,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.12,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,15.12,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.88,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,13.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.69,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.96,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.78,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,14.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.78,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,4.69,15.96,
LEGIONELLA PNEUMOPHILA AB IGM BY IFA,4360258,CDM,300,RC,,,outpatient,,,19,12.35,,12.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,17.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,15.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.09,18.05,
CHOLINESTERASE RBC,4360261,CDM,300,RC,,,outpatient,,,57.5,37.38,,38.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.39,54.63,
CALCITONIN,4360262,CDM,300,RC,82308,HCPCS,outpatient,,,192,124.8,,128.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,53.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.67,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,53.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.82,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,172.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,35.02,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,153.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,144,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,54.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,33.67,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,53.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,182.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,34.34,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,163.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.34,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,33.67,182.4,
TESTOSTERONE;TOTAL,4360263,CDM,300,RC,,,outpatient,,,162,105.3,,108.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,45.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,45.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,145.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,129.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,121.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,45.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,43.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,45.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,153.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,44.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,137.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.37,153.9,
IMMUNOFIXATION SERUM,4360264,CDM,300,RC,,,outpatient,,,68,44.2,,45.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,61.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,54.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,51,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.2,64.6,
"HYDROXYINDOLACETIC ACID, 5-(HIAA) URINE",4360265,CDM,300,RC,,,outpatient,,,93,60.45,,62.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,83.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,74.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.9,88.35,
AMIKACIN PEAK,4360266,CDM,300,RC,80150,HCPCS,outpatient,,,109.5,71.18,,73.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.95,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.72,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,98.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.71,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,87.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.95,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.33,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,93.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,65.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.33,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,18.95,104.03,
AMIKACIN TROUGH,4360268,CDM,300,RC,80150,HCPCS,outpatient,,,109.5,71.18,,73.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.95,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.72,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,98.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.71,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,87.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,82.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.95,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.33,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,93.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,65.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.33,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,18.95,104.03,
VALPROIC ACID; DEPAKENE,4360270,CDM,300,RC,,,outpatient,,,40.5,26.33,,27.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.84,38.48,
HEPATITIS Be ANTIGEN (HBeAg),4360272,CDM,300,RC,,,outpatient,,,83,53.95,,55.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,74.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.22,78.85,
ERYTHROPOIETIN,4360276,CDM,300,RC,82668,HCPCS,outpatient,,,81,52.65,,54.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.63,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.84,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,72.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.58,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,64.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.63,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.1,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,68.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.1,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,22.68,76.95,
VANCOMYCIN TROUGH,4360277,CDM,300,RC,80202,HCPCS,outpatient,,,35.5,23.08,,23.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.27,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.61,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,31.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.84,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,28.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.27,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.56,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,30.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,9.94,33.73,
COMPLEMENT C3,4360278,CDM,300,RC,,,outpatient,,,64.5,41.93,,43.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.27,61.28,
"CARDIOLIPIN ANTIBODIES IGM, IGA, IGG",4360281,CDM,300,RC,,,outpatient,,,218.86,142.26,,146.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,61.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,159.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,196.97,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,60.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,175.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,164.15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,61.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,58.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,207.92,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,59.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,186.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,131.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.59,207.92,
MYOGLOBIN SERUM,4360284,CDM,300,RC,,,outpatient,,,93,60.45,,62.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,83.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,74.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.9,88.35,
CAROTENE TOTAL,4360286,CDM,300,RC,,,outpatient,,,66.5,43.23,,44.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.8,63.18,
ESTRADIOL,4360289,CDM,300,RC,,,outpatient,,,35,22.75,,23.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.37,33.25,
PARIETAL CELL  AUTOANTIBODY,4360294,CDM,300,RC,,,outpatient,,,87,56.55,,58.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.29,82.65,
C-PEPTIDE,4360297,CDM,300,RC,84681,HCPCS,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.98,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.78,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.98,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.38,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.38,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,7.28,24.7,
ALKALINE PHOSPHATASE ISOENZYMES,4360300,CDM,300,RC,,,outpatient,,,64.5,41.93,,43.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.27,61.28,
CYTOLOGY NON-GYN,4360303,CDM,310,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
CANCER ANTIGEN 15-3,4360304,CDM,300,RC,,,outpatient,,,149,96.85,,99.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,134.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,41.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,119.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,111.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,42.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,40.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,126.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.89,141.55,
"DEOXYCORTISOL, 11- QUANT",4360305,CDM,300,RC,,,outpatient,,,210.5,136.83,,141.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,58.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,153.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,189.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,58.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,168.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,157.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,59.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,56.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,57.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,178.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,126.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.35,199.98,
WET MOUNT,4360306,CDM,300,RC,,,outpatient,,,17.5,11.38,,11.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,16.63,
"ALBUMIN; URINE, QUANTITATIVE",4360307,CDM,300,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
ROTAVIRUS (ANTIGEN),4360308,CDM,300,RC,,,outpatient,,,86,55.9,,57.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,77.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,68.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,64.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.02,81.7,
VENIPUNCTURE,4360311,CDM,300,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
VIRAL CULTURE,4360312,CDM,300,RC,,,outpatient,,,159.5,103.68,,106.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,44.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,116.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,143.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,44.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,127.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,119.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,45.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,42.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,151.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,43.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,135.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.7,151.53,
ADRENOCORTICOTROPIC HORMONE (ACTH),4360315,CDM,300,RC,,,outpatient,,,48.5,31.53,,32.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.98,46.08,
CALCIUM IONIZED,4360316,CDM,300,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
HEPATITIS B SURFACE ANTIBODY (HBsAb),4360317,CDM,300,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
ANTIBODY SCREEN,4360318,CDM,300,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
CORTISOL TOTAL; SERUM,4360319,CDM,300,RC,,,outpatient,,,71,46.15,,47.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,63.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,56.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,53.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.01,67.45,
FREE T4,4360320,CDM,300,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
DHEA SULFATE,4360322,CDM,300,RC,,,outpatient,,,57.5,37.38,,38.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.39,54.63,
CMV IGG QUANT,4360323,CDM,300,RC,,,outpatient,,,50.4,32.76,,33.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.8,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.84,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.11,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.49,47.88,
CMV IGM QUANT,4360324,CDM,300,RC,,,outpatient,,,72.9,47.39,,48.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,65.61,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,58.32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.26,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.97,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.41,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.52,69.26,
EBV NUCLEAR AG IGG,4360325,CDM,300,RC,,,outpatient,,,119.5,77.68,,80.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,107.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,95.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,89.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,101.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,71.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.99,113.53,
COMPATIBILITY TEST @ UNIT; IMMED SPIN,4360326,CDM,300,RC,,,outpatient,,,74.5,48.43,,49.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,59.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.94,70.78,
PSA; TOTAL,4360328,CDM,300,RC,,,outpatient,,,37,24.05,,24.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.9,35.15,
PROCAINAMIDE AND NAPA,4360329,CDM,300,RC,,,outpatient,,,120.5,78.33,,80.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,108.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.26,114.48,
FREE T3,4360330,CDM,300,RC,,,outpatient,,,111.5,72.48,,74.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,100.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,89.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,83.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,29.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,94.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,66.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.85,105.93,
PROGESTERONE,4360332,CDM,300,RC,84144,HCPCS,outpatient,,,178,115.7,,119.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,49.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.61,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,49.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,160.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.63,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,142.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,133.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,50.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.61,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,49.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.12,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,151.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.12,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,25.61,169.1,
B BURGDORFERI Ab REFLX IMMUNOBLOT,4360336,CDM,300,RC,,,outpatient,,,21.5,13.98,,14.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.76,20.43,
TROPONIN I (QUANTITATIVE),4360338,CDM,300,RC,,,outpatient,,,25,16.25,,16.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.69,23.75,
ETHOSUXIMIDE,4360339,CDM,300,RC,80168,HCPCS,outpatient,,,117.5,76.38,,78.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,32.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.55,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,32.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.47,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,105.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.37,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,88.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.55,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,32.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.96,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,99.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,70.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.96,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,20.55,111.63,
ESTRIOL UNCONJUGATED,4360340,CDM,300,RC,,,outpatient,,,173.5,112.78,,116.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,48.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,156.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,48.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,138.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,130.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,46.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,47.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,147.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,104.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.45,164.83,
LEAD BLOOD (DO NOT USE),4360341,CDM,300,RC,,,outpatient,,,87,56.55,,58.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.29,82.65,
KETONES SERUM,4360343,CDM,300,RC,82009,HCPCS,outpatient,,,13.5,8.78,,9.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.13,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.52,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,12.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.3,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,10.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.13,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.21,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,11.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.21,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,3.78,12.83,
IMIPRAMINE + DESIPRAMINE,4360344,CDM,300,RC,,,outpatient,,,123.5,80.28,,82.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,34.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,111.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,34.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,98.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,92.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,33.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,74.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.06,117.33,
AMITRIPTYLINE + NORTRIPTYLINE,4360346,CDM,300,RC,,,outpatient,,,129,83.85,,86.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,116.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,35.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,103.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,96.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,122.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,109.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.53,122.55,
RNP ANTIBODY,4360347,CDM,300,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
"VASOPRESSIN (ANTIDIURETIC HORMONE,ADH)",4360350,CDM,300,RC,,,outpatient,,,243,157.95,,162.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,177.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,218.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,67.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,194.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,182.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,68.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,230.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,66.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,206.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,145.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.05,230.85,
CALCIUM URINE RANDOM,4360352,CDM,300,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
FACTOR VIII ACTIVITY,4360354,CDM,300,RC,85240,HCPCS,outpatient,,,129,83.85,,86.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.52,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,36.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.61,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,116.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.42,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,103.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,96.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.52,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,36.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,122.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.97,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,109.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,22.52,122.55,
FACTOR IX  ACTIVITY,4360355,CDM,300,RC,,,outpatient,,,137,89.05,,91.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,123.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,109.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,102.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,38.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,36.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,130.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,116.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.67,130.15,
CANCER ANTIGEN 125,4360356,CDM,300,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
NORTRIPTYLINE,4360359,CDM,300,RC,G6037,HCPCS,outpatient,,,82,53.3,,54.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,73.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,65.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,61.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,69.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.95,77.9,
IMMUNOGLOBULIN E,4360360,CDM,300,RC,,,outpatient,,,180,117,,120.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,162,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,144,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,135,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,50.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,171,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,153,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.19,171,
"MICROALBUMIN, URINE, QUANTITATIVE",4360361,CDM,300,RC,,,outpatient,,,11.5,7.48,,7.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.08,10.93,
TRANSFERRIN,4360362,CDM,300,RC,84466,HCPCS,outpatient,,,154.5,100.43,,103.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.06,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,43.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.55,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,139.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.7,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,123.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,115.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.06,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,43.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.38,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,131.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,92.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,92.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,16.06,146.78,
DRUG TEST(S) 8-14 DRUG CLASS/MEDICINAL,4360363,CDM,300,RC,,,outpatient,,,283.5,184.28,,189.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,255.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,226.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,212.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,269.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,170.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,170.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.89,269.33,
RESPIRATORY SYNCYTIAL VIRUS,4360365,CDM,300,RC,,,outpatient,,,39.5,25.68,,26.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,35.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,31.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,29.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.57,37.53,
BASIC METABOLIC PANEL,4360367,CDM,300,RC,80048,HCPCS,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.65,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.63,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.08,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.65,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.86,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,2.24,11.63,
CHLAMYDIA  AMPLIFIED URINE,4360368,CDM,300,RC,,,outpatient,,,65.5,42.58,,43.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.53,62.23,
"SUSCEPTIBILITY STUDIES,MICRODILUTION",4360374,CDM,300,RC,,,outpatient,,,17.5,11.38,,11.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,16.63,
CULTURE THROAT,4360375,CDM,300,RC,,,outpatient,,,48,31.2,,32.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.85,45.6,
CULTURE URINE,4360377,CDM,300,RC,,,outpatient,,,8,5.2,,5.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.14,7.6,
CD4/CD8 ENUMERATION,4360379,CDM,300,RC,,,outpatient,,,58.5,38.03,,39.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.66,55.58,
LAMOTRIGINE,4360380,CDM,300,RC,80175,HCPCS,outpatient,,,16.5,10.73,,11.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.47,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.05,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,13.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.47,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.76,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,14.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,4.62,15.68,
HEPATITIS Be ANTIBODY (HBeAb),4360382,CDM,300,RC,,,outpatient,,,84,54.6,,56.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,67.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.49,79.8,
HEPATITIS A  TOTAL ANTIBODY,4360383,CDM,300,RC,,,outpatient,,,89,57.85,,59.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,80.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,71.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.83,84.55,
HEPATITIS C ANTIBODY,4360384,CDM,300,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
HIV 1/2 MULITSPOT (HIV CONFIRMATION),4360385,CDM,300,RC,,,outpatient,,,139,90.35,,93.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,125.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,111.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,104.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,118.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.21,132.05,
FECAL LEUKOCYTES,4360387,CDM,300,RC,89055,HCPCS,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.95,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.22,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.07,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.95,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.01,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.01,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,2.95,12.35,
HEPATITIS PANEL ACUTE,4360388,CDM,300,RC,,,outpatient,,,376.5,244.73,,252.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,105.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,105.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,274.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,338.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,104.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,301.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,282.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,106.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,100.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,105.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,357.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,102.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,320.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,225.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,225.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,100.79,357.68,
"HEPATITIS B CORE ANTIBODY, IgM",4360389,CDM,300,RC,,,outpatient,,,30.5,19.83,,20.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.16,28.98,
"HEPATITIS A ANTIBODY,  IgM",4360390,CDM,300,RC,,,outpatient,,,29,18.85,,19.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.76,27.55,
FOLIC ACID; SERUM,4360393,CDM,300,RC,,,outpatient,,,13.5,8.78,,9.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.61,12.83,
MYOGLOBIN URINE,4360397,CDM,300,RC,83874,HCPCS,outpatient,,,93,60.45,,62.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.24,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.75,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,83.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.89,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,74.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.24,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.56,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,79.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,16.24,88.35,
ANA WITH REFLEX TITER AND PATTERN,4360407,CDM,300,RC,,,outpatient,,,36.5,23.73,,24.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.77,34.68,
"ANTIBODY IDENTIFICATION,RBC ANTIBODIES",4360412,CDM,300,RC,,,outpatient,,,63,40.95,,42.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,56.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.87,59.85,
"BLOOD TYPING; Rh PHENOTYPING, COMPLETE",4360413,CDM,300,RC,,,outpatient,,,56.5,36.73,,37.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.13,53.68,
C-REACTIVE PROTEIN HIGH SENSITIVITY,4360418,CDM,300,RC,,,outpatient,,,42.5,27.63,,28.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.38,40.38,
PORPHYRINS ERYTHROCYTE,4360420,CDM,300,RC,,,outpatient,,,103.5,67.28,,69.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,93.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,82.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,77.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,87.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,62.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.71,98.33,
CH50,4360421,CDM,300,RC,,,outpatient,,,25.5,16.58,,17.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.83,24.23,
"HLA TYPING; A,B, OR C, MULTIPLE ANTIGENS",4360422,CDM,300,RC,,,outpatient,,,415.5,270.08,,278.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,116.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,116.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,303.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,373.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,115.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,332.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,311.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,117.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,111.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,116.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,394.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,113.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,353.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,249.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,249.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.23,394.73,
VARICELLA ZOSTER IGM,4360423,CDM,300,RC,,,outpatient,,,93,60.45,,62.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,83.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,74.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.9,88.35,
HIV 1/2 SCREEN W REFLX,4360424,CDM,300,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
MEASLES VIRUS IGG,4360425,CDM,300,RC,,,outpatient,,,93,60.45,,62.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,83.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,74.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.9,88.35,
TESTOSTERONE; FREE DON'T ORDER,4360426,CDM,300,RC,,,outpatient,,,155,100.75,,103.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,139.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,124,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,116.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,131.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.49,147.25,
POTASSIUM; URINE,4360427,CDM,300,RC,,,outpatient,,,14,9.1,,9.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,11.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.75,13.3,
COMPLEMENT C1q,4360428,CDM,300,RC,,,outpatient,,,64.5,41.93,,43.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.27,61.28,
ESTROGENS TOTAL; FRACTIONATED,4360429,CDM,300,RC,,,outpatient,,,40.5,26.33,,27.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.84,38.48,
"PLATELETS, PHERESIS",4360432,CDM,384,RC,,,outpatient,,,1322,859.3,,885.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,370.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,353.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,370.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,965.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1189.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,368.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1057.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,991.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,373.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,353.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,370.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1255.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,360.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1123.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,793.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,353.9,1255.9,
"HELICOBACTER PYLORI ANTIGEN ,STOOL",4360433,CDM,300,RC,,,outpatient,,,47,30.55,,31.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,42.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,37.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,35.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.58,44.65,
RENAL FUNCTION PANEL,4360434,CDM,300,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
ALDOSTERONE,4360435,CDM,300,RC,,,outpatient,,,175.5,114.08,,117.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,49.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,157.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,48.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,140.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,131.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,46.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,166.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,47.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,149.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,105.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.98,166.73,
ANTI-STREPTOLYSIN O (ASO) TITER,4360436,CDM,300,RC,,,outpatient,,,30,19.5,,20.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,27,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.03,28.5,
ANTISTREPTOLYSIN O; SCREEN,4360437,CDM,300,RC,,,outpatient,,,42,27.3,,28.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.24,39.9,
"CHLORIDE, URINE",4360439,CDM,300,RC,82436,HCPCS,outpatient,,,37,24.05,,24.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.32,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.91,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,33.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.57,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,29.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.32,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.45,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,31.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,6.32,35.15,
"GLUCOSE, CSF",4360442,CDM,300,RC,,,outpatient,,,29,18.85,,19.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.76,27.55,
LACTIC ACID PLASMA,4360443,CDM,300,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
PROSTATE SPECIFIC ANTIGEN (PSA);FREE,4360444,CDM,300,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
PREALBUMIN,4360445,CDM,300,RC,,,outpatient,,,18,11.7,,12.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.82,17.1,
SODIUM URINE RANDOM,4360446,CDM,300,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
THYROID STIMULATING IMMUNOGLOBULIN (TSI),4360447,CDM,300,RC,,,outpatient,,,63.5,41.28,,42.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,60.33,
"URIC ACID,OTHER SOURCE",4360448,CDM,300,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
CHROMATIN AB IGG(HISTONE AB),4360449,CDM,300,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
"CRYSTAL IDENTIFICATION, BODY FLUIDS",4360451,CDM,300,RC,,,outpatient,,,62.5,40.63,,41.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,56.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.73,59.38,
"CREATINE KINASE (CK), ISOENZYMES",4360452,CDM,300,RC,,,outpatient,,,96,62.4,,64.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,86.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.7,91.2,
COMPLEMENT C4,4360453,CDM,300,RC,,,outpatient,,,64.5,41.93,,43.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,51.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,48.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.27,61.28,
KEPPRA,4360454,CDM,300,RC,80177,HCPCS,outpatient,,,40,26,,26.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.47,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.05,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,32,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.47,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.76,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,11.2,38,
"PSA (MEDICARE > 50 YRS), SCREENING",4360455,CDM,300,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
BLOOD TYPING; RBC ANTIGENS OTHER THAN AB,4360456,CDM,300,RC,,,outpatient,,,201.77,131.15,,135.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,181.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,56.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,161.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,151.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,57.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,54.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,55.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,171.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,121.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,54.01,191.68,
"ANITBODY ELUTION (RBC), EACH ELUTION",4360461,CDM,300,RC,,,outpatient,,,106.49,69.22,,71.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,95.84,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,85.19,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,79.87,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,90.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.51,101.17,
EPSTEIN BARR VCA IGG,4360462,CDM,300,RC,,,outpatient,,,56.5,36.73,,37.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.13,53.68,
"COMPATABILITY TEST @ UNIT, INCUBATION TC",4360463,CDM,300,RC,,,outpatient,,,74.5,48.43,,49.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,59.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.94,70.78,
"COMPATABILITY TEST @ UNIT, ANTIGLOBULIN",4360464,CDM,300,RC,,,outpatient,,,74.5,48.43,,49.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,59.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.94,70.78,
ANTITHROMBIN III ACTIVITY,4360465,CDM,300,RC,85300,HCPCS,outpatient,,,85,55.25,,56.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.9,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.29,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,76.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.5,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.9,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.2,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,72.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.2,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,14.9,80.75,
PROTEIN C ANTIGEN TOTAL,4360466,CDM,300,RC,,,outpatient,,,87,56.55,,58.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.29,82.65,
PROTEIN S ANTIGEN TOTAL,4360467,CDM,300,RC,,,outpatient,,,152.88,99.37,,102.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,137.59,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,122.3,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,114.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,40.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.24,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,129.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,91.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.81,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.93,145.24,
CULTURE ORGANISM ID,4360470,CDM,300,RC,,,outpatient,,,16,10.4,,10.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.28,15.2,
METHYLMALONIC ACID;SERUM,4360473,CDM,300,RC,,,outpatient,,,26.5,17.23,,17.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.09,25.18,
"URINALYSIS, DIP STICK",4360474,CDM,300,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
EHRLICHIA CHAFFEENSIS AB IGG/IGM,4360479,CDM,300,RC,,,outpatient,,,73.5,47.78,,49.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,66.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,58.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.68,69.83,
"GONADOTROPIN, (HCG); QUANTITATIVE",4360480,CDM,300,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
"D-dimer, QUANTITATIVE",4360481,CDM,300,RC,,,outpatient,,,20.5,13.33,,13.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.49,19.48,
HOMOCYSTEINE,4360484,CDM,300,RC,83090,HCPCS,outpatient,,,33,21.45,,22.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.21,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.19,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,29.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.06,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,26.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,24.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.21,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.63,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,28.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.63,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,9.24,31.35,
FACTOR V ACTIVITY,4360485,CDM,300,RC,85220,HCPCS,outpatient,,,126.5,82.23,,84.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,35.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.19,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,35.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.26,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,113.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.08,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,101.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,94.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,35.77,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.19,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,35.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.63,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,107.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.63,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,22.19,120.18,
FACTOR II ACTIVITY,4360486,CDM,300,RC,,,outpatient,,,93,60.45,,62.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,83.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,74.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.9,88.35,
BLOOD PROCESSING/STORAGE PLASMA @ UNIT,4360487,CDM,390,RC,,,outpatient,,,246,159.9,,164.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,179.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,221.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,68.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,196.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,184.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,233.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,209.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.85,233.7,
BLOOD PROCESSING/STORAGE PLATELETS @ UNI,4360488,CDM,390,RC,,,outpatient,,,280.5,182.33,,187.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,78.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,204.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,252.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,224.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,210.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,79.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,266.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,76.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,238.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,168.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,168.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.09,266.48,
BLOOD PROCESSING/STORAGE RBC'S @ UNIT,4360489,CDM,390,RC,,,outpatient,,,615.5,400.08,,412.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,172.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,172.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,449.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,553.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,171.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,492.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,461.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,174.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,164.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,172.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,584.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,168.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,523.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,369.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,172.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,369.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,164.77,584.73,
"OCCULT BLOOD, GASTRIC",4360490,CDM,300,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
"PH, BODY FLUID, EXCEPT BLOOD",4360491,CDM,300,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
LIPOPROTEIN (a),4360492,CDM,300,RC,,,outpatient,,,93,60.45,,62.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,83.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.9,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,74.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.9,88.35,
"LIPOPROTEIN, BLOOD; QUANT PART NUMBERS",4360493,CDM,300,RC,,,outpatient,,,226.5,147.23,,151.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,63.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,165.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,203.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,63.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,181.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,169.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,64.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,215.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,192.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,135.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.63,215.18,
CATECHOLAMINES; FRACTIONATED 24 HR URINE,4360495,CDM,300,RC,,,outpatient,,,182,118.3,,121.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,163.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,145.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,136.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,154.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.72,172.9,
PRIMIDONE (MYSOLINE) LEVEL,4360505,CDM,300,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
CYCLOSPORINE A,4360510,CDM,300,RC,,,outpatient,,,22.5,14.63,,15.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.02,21.38,
ENDOMYSIAL IGG,4360512,CDM,300,RC,,,outpatient,,,87,56.55,,58.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.29,82.65,
FECAL FAT; QUANTITATIVE,4360514,CDM,300,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
"CREATININE CLEARANCE, 24 HR URINE",4360515,CDM,300,RC,,,outpatient,,,28.5,18.53,,19.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.63,27.08,
PROTEIN ELECTROPHORESIS URINE,4360516,CDM,300,RC,,,outpatient,,,59,38.35,,39.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,53.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.79,56.05,
INFLUENZA A,4360518,CDM,300,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
INFLUENZA B,4360519,CDM,300,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
PHENYTOIN ; FREE,4360520,CDM,300,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
VANCOMYCIN PEAK,4360521,CDM,300,RC,80202,HCPCS,outpatient,,,35.5,23.08,,23.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.27,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.61,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,31.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.84,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,28.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,26.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.27,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.56,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,30.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,9.94,33.73,
GENTAMYCIN PEAK,4360522,CDM,300,RC,,,outpatient,,,118.5,77.03,,79.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,106.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,94.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,88.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,100.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.72,112.58,
PROTEIN C ACTIVITY (FUNCTIONAL),4360606,CDM,300,RC,,,outpatient,,,180.18,117.12,,120.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,50.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,162.16,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,144.14,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,135.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,50.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,171.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,153.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,108.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.45,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.23,171.17,
BLOOD PROCESSING/STORAGE RBC'S LEUKO RED,4360607,CDM,390,RC,,,outpatient,,,416.5,270.73,,279.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,116.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,116.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,304.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,374.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,115.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,333.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,312.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,117.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,111.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,116.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,395.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,113.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,354.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.5,395.68,
BLOOD PROCESSING/STORAGE PLATELETS @ UNI,4360608,CDM,390,RC,,,outpatient,,,1322,859.3,,885.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,370.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,353.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,370.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,965.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1189.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,368.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1057.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,991.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,373.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,353.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,370.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1255.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,360.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1123.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,793.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,793.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,353.9,1255.9,
TRANSFUSION BLOOD OR BLOOD COMPONENTS,4360609,CDM,391,RC,,,outpatient,,,198.5,129.03,,133,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,55.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,178.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,158.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,148.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,188.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,168.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,119.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,119.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.14,188.58,
CANCER ANTIGEN 19-9,4360612,CDM,300,RC,,,outpatient,,,53.5,34.78,,35.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.32,50.83,
INTRINSIC FACTOR ANTIBODIES,4360613,CDM,300,RC,,,outpatient,,,65.7,42.71,,44.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.28,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.59,62.42,
HERPES VIRUS TYPE 1 IGG SERUM,4360614,CDM,300,RC,,,outpatient,,,16.5,10.73,,11.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.42,15.68,
SOUTHEASTERN RESP ALLERGY PANEL,4360615,CDM,300,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
5' NUCLEOTIDASE,4360616,CDM,300,RC,,,outpatient,,,81,52.65,,54.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.68,76.95,
BETA-2 MICROGLOBULIN,4360617,CDM,300,RC,82232,HCPCS,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.35,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.24,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.16,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.35,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.76,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.76,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,5.6,22.24,
INSULIN GROWTH FACTOR 1,4360618,CDM,300,RC,,,outpatient,,,91.2,59.28,,61.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,82.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72.96,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.64,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.52,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.41,86.64,
PLATELETS  EACH UNIT,4360621,CDM,384,RC,,,outpatient,,,280.5,182.33,,187.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,78.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,204.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,252.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,224.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,210.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,79.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,266.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,76.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,238.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,168.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,168.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.09,266.48,
HEPATITIS C GENOTYPE,4360700,CDM,300,RC,87902,HCPCS,outpatient,,,357.5,232.38,,239.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,100.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.67,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,100.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,119.88,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,321.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,114.06,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,286,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,268.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,101.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,109.67,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,100.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,339.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,111.86,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,303.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,214.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,214.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.86,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,100.1,339.63,
HEPATITIS C RNA QUANT,4360701,CDM,300,RC,,,outpatient,,,53.5,34.78,,35.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.32,50.83,
FOLIC ACID; RBC,4360702,CDM,300,RC,,,outpatient,,,45,29.25,,30.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,40.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.05,42.75,
"PROTEIN S ANTIGEN, FREE",4360707,CDM,300,RC,,,outpatient,,,201.11,130.72,,134.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,181,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,160.89,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,150.83,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.94,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,120.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.31,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.84,191.05,
ANTITHROMBIN III ANTIGEN,4360709,CDM,300,RC,,,outpatient,,,78,50.7,,52.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,70.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,62.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,58.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,66.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.88,74.1,
"OXALATE, URINE 24 HR OR RANDOM",4360719,CDM,300,RC,,,outpatient,,,92,59.8,,61.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,82.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,73.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,78.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.63,87.4,
CITRIC ACID 24 HR URINE OR RANDOM,4360720,CDM,300,RC,,,outpatient,,,199,129.35,,133.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,55.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,179.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,159.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,149.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,189.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,169.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.27,189.05,
KAPPA AND LAMBDA LIGHT CHAINS URINE,4360721,CDM,300,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
MITOCHONDRIAL  M2  ANTIBODIES,4360724,CDM,300,RC,,,outpatient,,,27.5,17.88,,18.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.36,26.13,
VON WILLEBRAND FACTOR ANTIGEN,4360725,CDM,300,RC,,,outpatient,,,165.5,107.58,,110.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,46.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,132.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,124.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,99.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.3,157.23,
CHROMIUM SERUM,4360726,CDM,300,RC,,,outpatient,,,145,94.25,,97.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,130.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,116,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,108.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,137.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,123.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.82,137.75,
"CELL COUNT AND DIFFERENTIAL, CSF",4360728,CDM,300,RC,,,outpatient,,,13.5,8.78,,9.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.61,12.83,
SODIUM FECAL,4360729,CDM,300,RC,,,outpatient,,,25.5,16.58,,17.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.83,24.23,
POTASSIUM FECAL,4360730,CDM,300,RC,,,outpatient,,,16.5,10.73,,11.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.42,15.68,
GIARDIA SPECIFIC ANTIGEN STOOL,4360731,CDM,300,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL,4360733,CDM,300,RC,,,outpatient,,,37,24.05,,24.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.9,35.15,
SIROLIMUS,4360734,CDM,300,RC,80195,HCPCS,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.25,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.87,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.94,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.25,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.6,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.6,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,4.76,18.87,
"SMOOTH MUSCLE Ab (F-ACTIN), IFA REFLEX",4360735,CDM,300,RC,,,outpatient,,,27.5,17.88,,18.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.36,26.13,
ACETYLCHOLINE RECEPTOR BLOCKING AB,4360736,CDM,300,RC,83519,HCPCS,outpatient,,,27.5,17.88,,18.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.99,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.57,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,24.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.67,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.99,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.33,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,23.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.33,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,7.7,26.13,
CHLAMYDIA TRACHOMATIS CULTURE,4360737,CDM,300,RC,,,outpatient,,,141,91.65,,94.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.75,133.95,
CRYPTOSPORIDIUM ANTIGEN,4360738,CDM,300,RC,87328,HCPCS,outpatient,,,86,55.9,,57.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.08,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.49,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,77.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.68,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,68.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,64.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.08,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.38,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,73.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.38,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,15.08,81.7,
STONE ANALYSIS,4361485,CDM,300,RC,,,outpatient,,,165.62,107.65,,110.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,149.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,46.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,132.5,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,124.22,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,99.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.34,157.34,
"GLUCOSE,SERUM",4365004,CDM,300,RC,,,outpatient,,,12.5,8.13,,8.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.35,11.88,
CDC TESTING SARS-CoV2 COVID-19,4369000,CDM,300,RC,,,outpatient,,,108,70.2,,72.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,97.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,30.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,86.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,81,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,91.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.91,102.6,
NON CDC TESTING SARS-CoV2 COVID-19,4369001,CDM,300,RC,,,outpatient,,,154,100.1,,103.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,138.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,123.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,115.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,130.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.23,146.3,
US CAROTID DOPPLER,4370001,CDM,921,RC,,,outpatient,,,399,259.35,,267.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,111.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,111.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,291.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,359.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,111.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,319.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,299.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,112.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,106.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,111.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,379.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,108.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,339.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,239.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,239.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,106.81,379.05,
US UPPER EXTREM ARTERY BILAT,4370004,CDM,921,RC,,,outpatient,,,483.5,314.28,,323.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,352.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,435.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,134.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,386.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,362.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,136.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,129.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,459.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,132.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,410.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,290.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,290.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,129.43,459.33,
US LOWER EXTREM ARTERY BILATE,4370006,CDM,921,RC,,,outpatient,,,483.5,314.28,,323.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,352.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,435.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,134.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,386.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,362.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,136.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,129.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,459.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,132.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,410.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,290.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,290.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,129.43,459.33,
US VENOUS EXTREMITY BILATERAL,4370008,CDM,921,RC,,,outpatient,,,238,154.7,,159.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,66.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,214.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,66.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,190.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,178.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,67.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,63.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,226.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,202.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.71,226.1,
US UPPER EXTREM ARTERY UNILATERAL,4370011,CDM,921,RC,,,outpatient,,,310.5,201.83,,208.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,86.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,86.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,226.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,279.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,86.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,248.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,232.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,87.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,83.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,86.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,294.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,84.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,263.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,186.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,186.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.12,294.98,
US LOWER EXTREMITY ARTERY UNILATERAL,4370012,CDM,921,RC,,,outpatient,,,295,191.75,,197.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,82.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,215.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,265.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,82.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,236,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,221.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,78.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,280.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,80.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,250.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,78.97,280.25,
US VENOUS EXTREMITY UNILATERAL,4370013,CDM,921,RC,,,outpatient,,,226,146.9,,151.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,63.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,203.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,180.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,169.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,214.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,192.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.5,214.7,
US DUPLEX OF AORTA,4370015,CDM,921,RC,,,outpatient,,,290,188.5,,194.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,81.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,81.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,211.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,261,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,232,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,217.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,82.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,81.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,275.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,79.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,246.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.63,275.5,
UNLISTED U/S PROCEDURE,4376999,CDM,402,RC,,,outpatient,,,45,29.25,,30.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,40.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.05,42.75,
MM DIAGNOSTIC MAMMO UNILATERAL W/CAD R,4377065,CDM,401,RC,,,outpatient,,,624,405.6,,418.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,174.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,167.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,174.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,455.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,561.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,173.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,499.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,468,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,176.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,167.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,174.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,592.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,170.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,530.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,374.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,374.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,167.04,592.8,
MM DIAGNOSTIC MAMMO BILATERAL W/CAD,4377066,CDM,401,RC,,,outpatient,,,739,480.35,,495.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,206.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,197.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,206.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,539.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,665.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,205.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,591.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,554.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,208.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,197.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,206.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,702.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,201.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,628.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,443.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,443.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,201.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,197.83,702.05,
MM SCREENING MAMMO BILATERAL 2 V W/CAD,4377067,CDM,403,RC,,,outpatient,,,424.5,275.93,,284.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,118.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,118.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,309.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,382.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,118.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,339.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,318.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,120.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,113.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,118.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,403.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,115.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,360.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,254.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,254.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.64,403.28,
BD DEXA STUD ONE OR MORE SITES AXIA SKEL,4380001,CDM,320,RC,,,outpatient,,,73.5,47.78,,49.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,66.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,58.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.68,69.83,
TACROLIMUS,4380197,CDM,300,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
DRUG TEST(s) presumptive SCREENING,4380307,CDM,300,RC,,,outpatient,,,542.5,352.63,,363.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,151.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,151.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,396.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,488.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,151.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,434,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,406.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,153.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,145.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,151.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,515.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,148.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,461.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,325.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,151.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,325.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,145.23,515.38,
VITAMIN D  25 OH TOTAL,4382306,CDM,300,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
"VITAMIN D 1,25-DIHYDROXY",4382652,CDM,300,RC,,,outpatient,,,48,31.2,,32.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.85,45.6,
"OSMOLALITY, SERUM",4383930,CDM,300,RC,83930,HCPCS,outpatient,,,8.5,5.53,,5.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.32,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.09,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,7.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.65,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,6.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.32,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,8.49,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,7.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.49,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,2.38,9.09,
PROTEIN URINE RANDOM,4384156,CDM,300,RC,,,outpatient,,,7.5,4.88,,5.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.01,7.13,
"PROTEIN,  CSF",4384157,CDM,300,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
VITAMIN B6,4384207,CDM,300,RC,,,outpatient,,,80,52,,53.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.42,76,
SEX HORMONE BINDING GLOBULIN (SHBG),4384270,CDM,300,RC,,,outpatient,,,105.5,68.58,,70.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,94.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,84.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,79.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.24,100.23,
VITAMIN B1 (THIAMINE),4384425,CDM,300,RC,,,outpatient,,,28,18.2,,18.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,25.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.5,26.6,
"PLATELET ANTIBODY, INDIRECT IgG",4386021,CDM,300,RC,,,outpatient,,,132,85.8,,88.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,118.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,105.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.34,125.4,
CYCLIC CITRULLINATED PEPTIDE (CCP) IGG,4386200,CDM,300,RC,,,outpatient,,,16,10.4,,10.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.28,15.2,
JO-1 ANTIBODY,4386235,CDM,300,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
"VDRL, SERUM WITH REFLEX TITER",4386592,CDM,300,RC,,,outpatient,,,13,8.45,,8.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,11.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,9.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.48,12.35,
FUNGAL ANTIBODIES,4386671,CDM,300,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
HTLV OR HIV ANTIBODY CONFIRMATORY TEST,4386689,CDM,300,RC,,,outpatient,,,139,90.35,,93.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,125.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,111.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,104.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,118.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.21,132.05,
ANTIBODY SARS CORONAVIRUS 2 SARS-CoV-2,4386769,CDM,300,RC,,,outpatient,,,211,137.15,,141.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,59.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,59.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,154.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,189.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,58.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,168.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,158.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,59.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,56.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,59.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,200.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,57.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,179.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.48,200.45,
CMV BY PCR QUALITATIVE,4387496,CDM,300,RC,,,outpatient,,,44,28.6,,29.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.78,41.8,
CMV DNA QUANTIFICATION BY PCR,4387497,CDM,300,RC,,,outpatient,,,53.5,34.78,,35.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.32,50.83,
"HERPES SIMPLEX PCR, FLUIDS",4387529,CDM,300,RC,,,outpatient,,,85,55.25,,56.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,76.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,68,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,72.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.75,80.75,
SARS-CoV2 COVID-19 AMPLIFIED PROBE TECHN,4387635,CDM,300,RC,,,outpatient,,,220,143,,147.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,198,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,61.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,176,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,165,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,62.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,58.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,209,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,187,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,58.89,209,
BK VIRUS QUANT PCR BLOOD,4387799,CDM,300,RC,,,outpatient,,,53.5,34.78,,35.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.32,50.83,
CULTURE BLOOD SET #2,4390001,CDM,300,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
PROTEIN 24HR URINE,4390002,CDM,300,RC,,,outpatient,,,7.5,4.88,,5.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.01,7.13,
CREATININE 24HR URINE,4390003,CDM,300,RC,,,outpatient,,,10.5,6.83,,7.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.81,9.98,
COBALT BLOOD,4390004,CDM,300,RC,,,outpatient,,,156.5,101.73,,104.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,140.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,125.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,117.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,44.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,148.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,133.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,93.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.9,148.68,
SJOGREN SS-A ANTIBODY,4390005,CDM,300,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
SJOGREN SS-B ANTIBODY,4390006,CDM,300,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
CANCER ANTIGEN 27.29,4390007,CDM,300,RC,,,outpatient,,,149,96.85,,99.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,134.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,41.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,119.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,111.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,42.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,40.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,126.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.89,141.55,
CALCIUM 24HR URINE,4390008,CDM,300,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
SODIUM 24HR URINE,4390009,CDM,300,RC,,,outpatient,,,15,9.75,,10.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.02,14.25,
URIC ACID 24HR URINE,4390010,CDM,300,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
MAGNESIUM 24HR URINE,4390011,CDM,300,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
T3 REVERSE,4390012,CDM,300,RC,84482,HCPCS,outpatient,,,19.5,12.68,,13.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.82,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,5.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.67,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,17.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.61,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,15.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,14.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.82,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,5.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.22,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,16.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,5.46,21.67,
KAPPA LAMBDA FREE LIGHT CHAINS,4390013,CDM,300,RC,,,outpatient,,,17,11.05,,11.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,15.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,13.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,12.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.55,16.15,
CELIAC SEROLOGY PANEL,4390014,CDM,300,RC,,,outpatient,,,27.5,17.88,,18.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.36,26.13,
HEPATITIS D(ELTA) AB,4390015,CDM,300,RC,,,outpatient,,,122.5,79.63,,82.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,34.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,110.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,34.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,98,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,91.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,116.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,73.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.79,116.38,
BILE ACIDS FRACTIONATED AND TOTAL,4390016,CDM,300,RC,,,outpatient,,,43,27.95,,28.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,32.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.51,40.85,
"UREA NITROGEN, URINE 24 HR OR RANDON",4390017,CDM,300,RC,,,outpatient,,,34,22.1,,22.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.1,32.3,
BK VIRUS QUANT PCR URINE,4390018,CDM,300,RC,,,outpatient,,,53.5,34.78,,35.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.32,50.83,
ANCA W/REFLEX MPO/PR3,4390019,CDM,300,RC,,,outpatient,,,87,56.55,,58.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.29,82.65,
OXCARBAZEPINE METABOLITE,4390020,CDM,300,RC,,,outpatient,,,95,61.75,,63.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,71.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.43,90.25,
"AFB CULTURE, NON-RESPIRATORY",4390021,CDM,300,RC,,,outpatient,,,52.5,34.13,,35.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.05,49.88,
LDH TOTAL BODY FLUID,4390023,CDM,300,RC,,,outpatient,,,7.5,4.88,,5.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.01,7.13,
AMYLASE  BODY FLUID,4390024,CDM,300,RC,,,outpatient,,,61.5,39.98,,41.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.46,58.43,
PROTEIN BODY FLUID,4390025,CDM,300,RC,,,outpatient,,,27,17.55,,18.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,21.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.23,25.65,
GLUCOSE BODY FLUID,4390026,CDM,300,RC,82945,HCPCS,outpatient,,,29,18.85,,19.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.93,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.39,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,26.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.13,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,23.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.93,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.03,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,24.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.03,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,4.93,27.55,
"CELL COUNT, BODY FLUID (SEND OUT)",4390027,CDM,300,RC,,,outpatient,,,13.5,8.78,,9.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.61,12.83,
GRAM STAIN (REF LAB),4390028,CDM,300,RC,,,outpatient,,,5.5,3.58,,3.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.47,5.23,
SCL-70 ANTIBODY,4390029,CDM,300,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
CENTROMERE AB,4390030,CDM,300,RC,86235,HCPCS,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.55,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.65,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.45,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.55,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,12.88,43.7,
CULTURE MRSA,4390031,CDM,300,RC,,,outpatient,,,48,31.2,,32.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,43.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,38.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,40.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.85,45.6,
"COPPER, URINE",4390032,CDM,300,RC,,,outpatient,,,15.5,10.08,,10.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,13.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.15,14.73,
VITAMIN E ALPHA,4390033,CDM,300,RC,,,outpatient,,,29,18.85,,19.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,26.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,8.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,23.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,21.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.76,27.55,
VITAMIN E GAMMA,4390034,CDM,300,RC,,,outpatient,,,23.5,15.28,,15.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.29,22.33,
TOPIRAMATE,4390037,CDM,300,RC,80201,HCPCS,outpatient,,,30.5,19.83,,20.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,8.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.99,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,8.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.39,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,27.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.59,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,24.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,22.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,8.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.99,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,8.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.29,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,25.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.29,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,8.54,28.98,
VITAMIN A,4390038,CDM,300,RC,84590,HCPCS,outpatient,,,14.5,9.43,,9.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.58,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.95,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,13.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.16,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,11.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.58,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.87,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,12.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.87,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,4.06,15.95,
SMITH (Sm) ANTIBODY,4390039,CDM,300,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
FRAGILE X SCREEN,4390040,CDM,300,RC,,,outpatient,,,83,53.95,,55.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,74.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.22,78.85,
"LEAD BLOOD, VENIPUNCTURE",4390041,CDM,300,RC,,,outpatient,,,87,56.55,,58.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.29,82.65,
RNA POLYMERASE III AB,4390042,CDM,300,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
HEMOCHROMATOSIS (HFE) 3 MUTATION,4390043,CDM,300,RC,,,outpatient,,,277.5,180.38,,185.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,77.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,202.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,249.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,77.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,222,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,208.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,78.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,74.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,77.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,263.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,75.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,235.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,166.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,166.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.29,263.63,
CLOSTRIDIUM DIFFICLE TOXIN,4390044,CDM,300,RC,,,outpatient,,,57.5,37.38,,38.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.39,54.63,
CLOSTRIDIUM DIFFICLE ANTIGEN,4390045,CDM,300,RC,,,outpatient,,,56.5,36.73,,37.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.13,53.68,
FUNGUS CULTURE AND STAIN,4390046,CDM,300,RC,,,outpatient,,,61.5,39.98,,41.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,55.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,49.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,46.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,16.46,58.43,
THYROGLOBULIN QUANT AND ANTIBODY,4390048,CDM,300,RC,,,outpatient,,,20,13,,13.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.35,19,
LATEX ALLERGEN,4390049,CDM,300,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
URIC ACID BODY FLUID,4390050,CDM,300,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
N-TELOPEPTIDE RANDOM URINE,4390051,CDM,300,RC,,,outpatient,,,131,85.15,,87.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,98.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.07,124.45,
EOSINOPHIL COUNT URINE,4390052,CDM,300,RC,,,outpatient,,,4,2.6,,2.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.07,3.8,
ANTI-MULLERIAN HORMONE (AMH),4390053,CDM,300,RC,,,outpatient,,,55,35.75,,36.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,41.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.72,52.25,
"VALPROIC ACID, FREE AND TOTAL",4390054,CDM,300,RC,,,outpatient,,,40.5,26.33,,27.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,36.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,32.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,30.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.84,38.48,
STREP PNEUMO ANTIBODIES IGG(14),4390055,CDM,300,RC,,,outpatient,,,143,92.95,,95.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,128.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,114.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,107.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,40.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,38.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,135.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,121.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,85.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.28,135.85,
DEXAMETHASONE,4390056,CDM,300,RC,,,outpatient,,,86,55.9,,57.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,77.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,68.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,64.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.02,81.7,
HIV-1 PCR QUANTITATIVE,4390058,CDM,300,RC,,,outpatient,,,370.5,240.83,,248.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,103.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,270.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,333.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,103.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,296.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,277.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,104.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,99.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,351.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,101.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,314.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,222.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,222.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,99.18,351.98,
TISSUE TRANSGLUTAMINASE IgA,4390059,CDM,300,RC,,,outpatient,,,27.5,17.88,,18.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,24.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,7.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7.36,26.13,
EPSTEIN BARR VCA IGM,4390061,CDM,300,RC,,,outpatient,,,56.5,36.73,,37.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.13,53.68,
EPSTEIN BARR EARLY ANTIGEN IgG,4390062,CDM,300,RC,,,outpatient,,,100,65,,67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.77,95,
"CULTURE, AFB",4390064,CDM,300,RC,,,outpatient,,,52.5,34.13,,35.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.05,49.88,
CONCENTRATION FOR INFECTIOUS AGENTS,4390065,CDM,300,RC,,,outpatient,,,52.5,34.13,,35.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.33,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.05,49.88,
ISLET CELL AB IGG,4390068,CDM,300,RC,,,outpatient,,,140,91,,93.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.48,133,
DIHYDROTESTOSTERONE,4390069,CDM,300,RC,82642,HCPCS,outpatient,,,150,97.5,,100.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.02,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,135,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.06,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,120,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,112.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,42.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.02,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.54,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,127.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.54,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,26.02,142.5,
IBD PANEL,4390070,CDM,300,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
EBV PCR VIRAL LOAD,4390071,CDM,300,RC,,,outpatient,,,53.5,34.78,,35.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.32,50.83,
C1 ESTERASE INHIBITOR FUNCTIONAL,4390072,CDM,300,RC,,,outpatient,,,86,55.9,,57.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,77.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,68.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,64.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.02,81.7,
CRYOGLOBULIN + % CRIT,4390073,CDM,300,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
"METANEPHRINES, PLASMA (FREE)",4390074,CDM,300,RC,,,outpatient,,,73,47.45,,48.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,65.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,58.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.54,69.35,
BARTONELLA HENSELAE IGG/IGM,4390075,CDM,300,RC,,,outpatient,,,149,96.85,,99.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,134.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,41.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,119.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,111.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,42.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,40.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,126.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.89,141.55,
"NICOTINE + COTININE, SERUM",4390076,CDM,300,RC,,,outpatient,,,682.5,443.63,,457.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,191.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,182.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,191.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,498.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,614.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,190.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,546,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,511.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,193.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,182.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,191.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,648.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,186.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,580.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,409.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,191.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,409.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,182.71,648.38,
"TRICHOMONAS, FEMALE (APTIMA)",4390077,CDM,300,RC,,,outpatient,,,51,33.15,,34.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.65,48.45,
ACETYLCHOLINE RECEPTOR BINDING AUTOAB,4390078,CDM,300,RC,,,outpatient,,,96,62.4,,64.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,86.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,72,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,91.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,81.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.7,91.2,
FACTOR V LEIDEN,4390079,CDM,300,RC,,,outpatient,,,615.55,400.11,,412.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,172.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,172.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,449.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,554,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,171.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,492.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,461.66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,174.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,164.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,172.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,584.77,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,168.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,523.22,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,369.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,172.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,369.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,164.78,584.77,
HALOPERIDOL,4390080,CDM,300,RC,,,outpatient,,,104.5,67.93,,70.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,94.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.09,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,83.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,78.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,88.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.97,99.28,
THIN PREP,4390082,CDM,300,RC,,,outpatient,,,189,122.85,,126.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,52.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,137.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,170.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,52.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,151.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,141.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,53.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,50.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,179.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,51.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,160.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.6,179.55,
FECAL LACTOFERRIN,4390083,CDM,300,RC,,,outpatient,,,84,54.6,,56.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,67.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.49,79.8,
ACETYLCHOLINE RECEPTOR MODULATING AB,4390084,CDM,300,RC,83519,HCPCS,outpatient,,,27.5,17.88,,18.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.99,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.57,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,24.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.67,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,22,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,20.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,16.99,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.33,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,23.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.33,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,7.7,26.13,
"NEISSERIA GONORRHOEAE, AMPLIFIED SWAB",4390085,CDM,300,RC,,,outpatient,,,81,52.65,,54.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.68,76.95,
CHLAMYDIA  AMPLIFIED SWAB,4390086,CDM,300,RC,,,outpatient,,,65.5,42.58,,43.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.53,62.23,
IGF BINDING PROTEIN 3,4390087,CDM,300,RC,,,outpatient,,,101,65.65,,67.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.04,95.95,
DRUG TEST(S) DEFINITIVE 8-14 DRUGS,4390088,CDM,300,RC,,,outpatient,,,283.5,184.28,,189.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,255.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,226.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,212.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.89,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,269.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,170.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,170.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.89,269.33,
NASH FIBROSURE-LABCORP TEST,4390089,CDM,300,RC,,,outpatient,,,141,91.65,,94.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.75,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.75,133.95,
APOLIPOPROTEIN A-1,4390090,CDM,300,RC,82172,HCPCS,outpatient,,,111.5,72.48,,74.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.49,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.3,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,100.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.27,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,89.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,83.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.49,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.88,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,94.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,66.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.88,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,19.49,105.93,
APOLIPOPROTEIN B,4390091,CDM,300,RC,82172,HCPCS,outpatient,,,111.5,72.48,,74.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.49,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.3,100,,,fee schedule,100% BCBS PPO fee schedule for outpatient setting,100.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.27,104,,,fee schedule,104% GA Medicaid fee schedule for outpatient setting,89.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,83.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.49,100,,,fee schedule,100% GA Medicaid fee schedule for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.88,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,94.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,66.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.88,102,,,fee schedule,102% GA Medicaid fee schedule for outpatient setting,19.49,105.93,
SOLUBLE TRANSFERRIN REC,4390092,CDM,300,RC,,,outpatient,,,260.5,169.33,,174.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,72.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,234.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,72.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,208.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,195.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,73.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,69.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,247.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,71.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,221.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,156.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,69.74,247.48,
MTHFR,4390093,CDM,300,RC,,,outpatient,,,187,121.55,,125.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,52.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,136.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,168.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,52.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,149.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,140.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,52.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,50.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,177.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,51.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,158.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.06,177.65,
DRUG TEST(S) DEFINITIVE 15-21 DRUGS,4390094,CDM,300,RC,,,outpatient,,,1064,691.6,,712.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,297.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,284.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,297.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,776.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,957.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,296.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,851.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,798,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,300.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,284.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,297.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1010.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,290.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,904.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,638.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,638.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,284.83,1010.8,
DRUG TEST(S) DEFINITIVE 22 or > DRUGS,4390095,CDM,300,RC,,,outpatient,,,1321,858.65,,885.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,369.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,353.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,369.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,964.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1188.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,367.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1056.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,990.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,373.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,353.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,369.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1254.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,360.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1122.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,792.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,792.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,353.63,1254.95,
AMPHETAMINES 1 OR 2,4390096,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
AMPHETAMINES 3 OR 4,4390098,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
"ANTIDEPRESSANTS,SSRI 1 OR 2",4390099,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
"ANTIDEPRESSANTS,SSRI 3-5",4390100,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
"ANTIDEPRESSANTS,SSRI 6 OR MORE",4390101,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
BARBITURATES,4390102,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
BENZODIAZEPINES,4390103,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
BUPRENORPHINE,4390104,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
"CANNABINOIDS,NATURAL",4390105,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
COCAINE,4390106,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
FENTANYL SERUM/PLASMA QUANT,4390107,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
ECSTASY (MDMA),4390108,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
"GABAPENTIN, URINE",4390109,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
METHADONE,4390110,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
METHYLPHENIDATE,4390111,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
OPIATES,4390112,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
OPIOIDS 1 OR 2,4390113,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
OPIOIDS 3 OR 4,4390114,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
OPIOIDS 5 OR MORE,4390115,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
PREGABALIN,4390116,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
SEDATIVE HYPNOTICS (INCL SLEEP AIDS),4390117,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
SKELETAL MUSCLE RELAXANTS,4390118,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
TAPENTADOL,4390119,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
TRAMADOL,4390120,CDM,300,RC,,,outpatient,,,612,397.8,,410.04,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,446.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,550.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,170.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,489.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,459,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,173.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,163.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,520.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,171.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,163.83,581.4,
DRUG TEST(S) DEFINITIVE 1-7 DRUGS,4390121,CDM,300,RC,,,outpatient,,,57,37.05,,38.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.26,54.15,
"TRICHOMONAS, MALE (APTIMA)",4390122,CDM,300,RC,,,outpatient,,,51,33.15,,34.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.65,48.45,
PRO-BNP,4390123,CDM,300,RC,,,outpatient,,,79,51.35,,52.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.67,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,71.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,63.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,59.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,67.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.15,75.05,
EKG ROUTINE 12 LEAD,4440001,CDM,730,RC,,,outpatient,,,158,102.7,,105.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,142.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,126.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,118.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,44.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,42.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,43.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.3,150.1,
"RHYTHM ECG,TRACING ONLY W/O INTERP/REPOR",4440003,CDM,730,RC,,,outpatient,,,65.5,42.58,,43.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.53,62.23,
EKG INTERP/ REPORT,4440004,CDM,730,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
EKG EA ADD'L,4440012,CDM,730,RC,,,outpatient,,,158,102.7,,105.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,142.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,126.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,118.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,44.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,42.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,43.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.3,150.1,
PULMONARY STRESS TEST (6mins),4540003,CDM,460,RC,,,outpatient,,,98,63.7,,65.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.23,93.1,
OXYGEN (O2) SENSOR FOR PULSE OX,4540009,CDM,270,RC,,,outpatient,,,63.5,41.28,,42.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,57.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,17.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,50.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,47.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,17.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,38.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17,60.33,
TRACH CARE,4540015,CDM,272,RC,,,outpatient,,,165,107.25,,110.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,132,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.17,156.75,
OXYGEN INITIAL SETUP,4540018,CDM,271,RC,,,outpatient,,,97,63.05,,64.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,87.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,77.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,72.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,92.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,82.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.97,92.15,
CROUPE TENT 1ST HOUR,4540025,CDM,270,RC,,,outpatient,,,201,130.65,,134.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,180.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,160.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,150.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.81,190.95,
CROUPE TENT SUBSQ HOUR,4540026,CDM,270,RC,,,outpatient,,,87,56.55,,58.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.29,82.65,
CPT MANIPULATION CHEST WALL; INITIAL,4540041,CDM,410,RC,,,outpatient,,,56,36.4,,37.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.99,53.2,
INTUBATION ENDOTRACHEAL EMERGENCY,4540045,CDM,410,RC,,,outpatient,,,183,118.95,,122.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,164.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,146.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,137.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.99,173.85,
CARDIOPULMONARY RESUSCITATION,4540046,CDM,480,RC,,,outpatient,,,237,154.05,,158.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,213.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,65.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,189.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,177.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,67.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,63.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,225.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,201.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,142.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.44,225.15,
ABG GASES BLOOD ANY COMBINATION,4540050,CDM,300,RC,,,outpatient,,,139.5,90.68,,93.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,125.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,111.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,104.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,118.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,83.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.34,132.53,
PFT SCREENING,4540056,CDM,460,RC,,,outpatient,,,838.5,545.03,,561.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,234.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,224.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,234.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,612.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,754.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,233.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,670.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,628.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,237.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,224.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,234.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,796.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,228.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,712.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,503.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,503.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,224.47,796.58,
HIGH FLOW NASAL CANNULA,4540057,CDM,270,RC,,,outpatient,,,23,14.95,,15.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.16,21.85,
HOLTER MONITOR up to 48hr RECORDING,4540058,CDM,731,RC,,,outpatient,,,351,228.15,,235.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,98.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,256.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,315.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,97.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,280.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,263.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,99.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,93.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,333.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,95.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,298.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,210.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,98.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.96,333.45,
HIGH FLOW OXYGEN SETUP,4540064,CDM,271,RC,,,outpatient,,,117,76.05,,78.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,32.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,105.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,93.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,87.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,99.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.32,111.15,
HIGH FLOW WATER BAG (2L),4540065,CDM,270,RC,,,outpatient,,,6,3.9,,4.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.61,5.7,
OXYGEN (SPECIAL AREA),4540076,CDM,271,RC,,,outpatient,,,66,42.9,,44.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.67,62.7,
ARTERIAL PUNCTURE,4540078,CDM,450,RC,36600,HCPCS,outpatient,,,65.5,42.58,,43.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,58.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.53,62.23,
VENTILATION ASSIST; INITIAL DAY,4540081,CDM,410,RC,,,outpatient,,,465,302.25,,311.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,130.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,339.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,418.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,129.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,372,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,348.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,131.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,124.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,441.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,126.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,395.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,279,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,279,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,124.48,441.75,
PULSE OXIMETER BY CONT OVERNIGHT MONITOR,4540093,CDM,460,RC,,,outpatient,,,205.5,133.58,,137.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,184.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,57.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,164.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,154.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,58.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,55.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,195.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,56.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,174.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,123.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.01,195.23,
AERO CHAMBER,4540102,CDM,270,RC,,,outpatient,,,80,52,,53.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.42,76,
"MANIPULATION CHEST WALL, SUBSEQUENT",4540106,CDM,410,RC,,,outpatient,,,56,36.4,,37.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.99,53.2,
TRACH TIES,4540111,CDM,410,RC,,,outpatient,,,26,16.9,,17.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,23.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,7.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,20.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,19.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,7.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.96,24.7,
TRACH CANNULA,4540112,CDM,410,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
BALLARD 14-LINE SUCTION KIT  #220870,4540114,CDM,270,RC,,,outpatient,,,105,68.25,,70.35,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,94.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,84,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,78.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.11,99.75,
NASOTRACHEAL SUCTION/SPUTUM ASPIRATION,4540119,CDM,410,RC,,,outpatient,,,69.5,45.18,,46.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,19.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,18.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,62.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,19.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,55.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,52.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,19.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,18.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,19.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,59.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,41.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18.61,66.03,
OXYGEN SUBSEQUENT (PER HOUR),4540120,CDM,270,RC,,,outpatient,,,22.5,14.63,,15.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.02,21.38,
CPAP CONTINUOUS POSITIVE AIRWAY VENTILA,4540127,CDM,410,RC,,,outpatient,,,116.5,75.73,,78.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,32.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,104.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,93.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,87.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,32.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,110.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,99.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,69.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.19,110.68,
CONT INH TX W/MED INITIAL,4540129,CDM,410,RC,,,outpatient,,,390.5,253.83,,261.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,285.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,351.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,108.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,312.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,292.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,110.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,104.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,370.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,106.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,331.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,234.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.54,370.98,
CONT INH TX W/MED EA  ADD'L TX,4540130,CDM,410,RC,,,outpatient,,,36,23.4,,24.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,32.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,28.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.18,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.64,34.2,
C-PAP MASK,4540135,CDM,270,RC,,,outpatient,,,174,113.1,,116.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,48.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,156.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,48.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,139.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,130.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,46.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,48.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,165.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,47.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,147.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.58,165.3,
HHN NEBULIZER TX SUB,4540140,CDM,410,RC,,,outpatient,,,118,76.7,,79.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,106.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,94.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,88.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,100.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.59,112.1,
MDI TX,4540141,CDM,410,RC,,,outpatient,,,118,76.7,,79.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,106.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,94.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,88.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,100.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.59,112.1,
PULSE OXIMETRY SINGLE;  EA ADD'L,4540192,CDM,460,RC,,,outpatient,,,6.5,4.23,,4.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1.74,6.18,
INITIAL TREATMENT HAND HELD,4540195,CDM,460,RC,,,outpatient,,,118,76.7,,79.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,106.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,32.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,94.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,88.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,33.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,31.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,32.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,100.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.59,112.1,
PFT PRE AND POST,4540196,CDM,460,RC,,,outpatient,,,838.5,545.03,,561.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,234.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,224.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,234.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,612.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,754.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,233.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,670.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,628.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,237.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,224.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,234.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,796.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,228.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,712.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,503.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,503.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,224.47,796.58,
SMOKING & TOBACCO USE CESSATION VISIT,4599406,CDM,942,RC,,,outpatient,,,37,24.05,,24.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,33.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,29.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,27.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.9,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,31.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.9,35.15,
PT ELECTRICL STIM UNATTENDED WOUND CARE,4620003,CDM,420,RC,L5631,HCPCS,outpatient,,,83,53.95,,55.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,74.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.22,78.85,
PT ULTRASOUND/PHONOPHERESIS EA 15 MINS,4620004,CDM,420,RC,L5649,HCPCS,outpatient,,,105.5,68.58,,70.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,94.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,84.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,79.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.24,100.23,
PT THERAP ACTIV EA 15 MIN,4620006,CDM,420,RC,L5652,HCPCS,outpatient,,,76,49.4,,50.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,68.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,60.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.35,72.2,
PT MASSAGE EA 15 MINS,4620007,CDM,420,RC,L5695,HCPCS,outpatient,,,45.5,29.58,,30.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,40.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.18,43.23,
PT NEUROMUSCULAR REED EA 15 MIN,4620008,CDM,420,RC,L5812,HCPCS,outpatient,,,140.5,91.33,,94.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.61,133.48,
PT GROUP,4620009,CDM,420,RC,L5972,HCPCS,outpatient,,,34.5,22.43,,23.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.24,32.78,
PT ELECTRICAL STIM UNATTENDED,4620013,CDM,420,RC,L1970,HCPCS,outpatient,,,83,53.95,,55.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,74.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.22,78.85,
PT PARAFFIN BATH,4620016,CDM,420,RC,97018,HCPCS,outpatient,,,23.5,15.28,,15.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.29,22.33,
PT TRACTION MECHANICAL,4620019,CDM,420,RC,,,outpatient,,,133.5,86.78,,89.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,120.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,100.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,126.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,80.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.74,126.83,
PT MANUAL THERAPY TECHNIQUES EA 15 MIN,4620020,CDM,420,RC,,,outpatient,,,263,170.95,,176.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,73.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,236.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,73.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,210.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,197.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,249.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,71.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,223.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.41,249.85,
PT THERAPEUTIC EXERCISE EA 15 MINS,4620022,CDM,420,RC,,,outpatient,,,130,84.5,,87.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.8,123.5,
PT WHIRLPOOL,4620026,CDM,420,RC,,,outpatient,,,168.5,109.53,,112.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,151.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,46.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,134.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,126.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,143.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.11,160.08,
PT GAIT TRAINING EA 15MIN,4620037,CDM,420,RC,,,outpatient,,,59.5,38.68,,39.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,53.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,47.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,44.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,16.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.93,56.53,
PT IONTOPHORESIS EA 15 MINS,4620045,CDM,420,RC,,,outpatient,,,195.5,127.08,,130.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,175.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,156.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,146.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,185.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,166.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,117.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.34,185.73,
PT ACTIVITIES OF DAILY LIVING EA 15 MIN,4620059,CDM,420,RC,,,outpatient,,,66.5,43.23,,44.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.8,63.18,
PT MUSCLE TESTING MANUAL HAND,4620060,CDM,420,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
PT MUSCLE TEST MANUAL TOTAL BODY W/O HAN,4620061,CDM,420,RC,,,outpatient,,,66.5,43.23,,44.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.8,63.18,
PT MUSCLE TEST MANUAL TOTAL BODY W/HANDS,4620062,CDM,420,RC,,,outpatient,,,90,58.5,,60.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.09,85.5,
PT PHYSICAL PERFORMANCE TEST EA 15 MIN,4620066,CDM,420,RC,,,outpatient,,,101,65.65,,67.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.04,95.95,
PT PROSTHETIC TRAINING EA 15 MINS,4620073,CDM,420,RC,,,outpatient,,,50.5,32.83,,33.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.52,47.98,
PT ROM EXTREMITY/TRUNK,4620077,CDM,420,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
PT SELECTIVE DEBRIDEMENT1st 20CM,4620078,CDM,420,RC,,,outpatient,,,129.83,84.39,,86.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,116.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,103.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,77.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.76,123.34,
PT ROM HAND,4620079,CDM,420,RC,,,outpatient,,,18.5,12.03,,12.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.95,17.58,
PT ICE MASSAGE EA 15 MINS,4620083,CDM,420,RC,,,outpatient,,,75.5,49.08,,50.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,60.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,56.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,45.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.21,71.73,
PT VASOPNEUMATIC DEVICE,4620084,CDM,420,RC,,,outpatient,,,54.5,35.43,,36.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.59,51.78,
PT ELECTRICAL STIM EA 15 MIN  ATTENDED,4620085,CDM,420,RC,,,outpatient,,,182,118.3,,121.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,163.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,145.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,136.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,154.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.72,172.9,
PT WHEELCHAIR MGMT EA 15 MIN,4620086,CDM,420,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
PT CONTRAST BATHS EA 15 MINS,4620087,CDM,420,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
PT STRAPPING ANKLE AND OR FOOT,4620089,CDM,420,RC,,,outpatient,,,99.05,64.38,,66.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.52,94.1,
PT STRAPPING KNEE,4620091,CDM,420,RC,,,outpatient,,,112.5,73.13,,75.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,101.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,90,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.12,106.88,
PT STRAPPING UNNA BOOT,4620092,CDM,420,RC,,,outpatient,,,107.5,69.88,,72.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,96.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,80.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,91.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,64.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.78,102.13,
PT ORTHOTIC(S) FIT AND TRAIN EA 15 MIN,4620094,CDM,420,RC,,,outpatient,,,65.7,42.71,,44.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.28,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.59,62.42,
PT NEGATIVE PRESS WOUND THERAPY < 50CM,4620095,CDM,420,RC,,,outpatient,,,129.83,84.39,,86.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,116.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,103.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,77.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.76,123.34,
PT NEGATIVE PRESSURE WOUND THERAPY PUMP,4620096,CDM,420,RC,,,outpatient,,,131,85.15,,87.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,98.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.07,124.45,
PT APPLIC MULTI-LAYER COMPRESS BEL KNEE,4620097,CDM,420,RC,,,outpatient,,,99.05,64.38,,66.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.52,94.1,
PT G8978 MOBILITY CURRENT STATUS,4620103,CDM,420,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
PT G8979 MOBILITY GOAL STATUS,4620104,CDM,420,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
PT G8980 MOBILITY D/C STATUS,4620105,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8984 CARRYING CURRENT STATUS,4620106,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8985 CARRYING GOAL STATUS,4620107,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8986 CARRYING D/C STATUS,4620108,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8987 SELF CARE CURRENT STATUS,4620109,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8988 SELF CARE GOAL STATUS,4620110,CDM,420,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
PT G8989 SELF CARE D/C STATUS,4620111,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT APPLIC MULTI-LAYER COMPRESS LOWER EXT,4620112,CDM,420,RC,,,outpatient,,,99.05,64.38,,66.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.52,94.1,
PT SELECTIVE DEBRIDEMENT ea ADD'L 20CM,4620113,CDM,420,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
PT NEGATIVE PRESS WOUND THERAPY > 50CM,4620114,CDM,420,RC,,,outpatient,,,231.1,150.22,,154.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,64.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,64.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,168.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,207.99,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,64.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,184.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,173.33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,65.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,61.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,64.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,219.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,63.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,196.44,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,138.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.71,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.87,219.55,
PT G8990 OTHER PT/OT CURRENT STATUS,4620116,CDM,420,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
PT G8991 OTHER PT/OT GOAL STATUS,4620117,CDM,420,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
PT G8992 OTHER PT/OT D/C STATUS,4620118,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8993 SUB PT/OT CURRENT STATUS,4620119,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8994 SUB PT/OT GOAL STATUS,4620120,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8995 SUB PT/OT D/C STATUS,4620121,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G9165 ATTEN CURRENT STATUS,4620122,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G9166 ATTEN GOAL STATUS,4620123,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G9167 ATTEN D/C STATUS,4620124,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G9168 MEMORY CURRENT STATUS,4620125,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G9169 MEMORY GOAL STATUS,4620126,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G9170 MEMORY D/C STATUS,4620127,CDM,420,RC,,,outpatient,,,0.09,0.06,,0.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.09,
PT G8981 BODY POS CURRENT STATUS,4620128,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8982 BODY POS GOAL STATUS,4620129,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT G8983 BODY POS D/C STATUS,4620130,CDM,420,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
PT EVALUATION LOW COMPLEXITY,4697161,CDM,424,RC,97161,HCPCS,outpatient,,,290,188.5,,194.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,81.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,81.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,211.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,261,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,232,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,217.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,82.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,81.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,275.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,79.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,246.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.63,275.5,
PT EVALUATION MODERATE COMPLEXITY,4697162,CDM,424,RC,97162,HCPCS,outpatient,,,167,108.55,,111.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,150.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,46.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,133.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,125.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,158.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,141.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,100.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.71,158.65,
PT EVALUATION HIGH COMPLEXITY,4697163,CDM,424,RC,97163,HCPCS,outpatient,,,147,95.55,,98.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,41.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,132.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,117.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,110.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,41.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,139.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,40.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,124.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.35,139.65,
PT RE-EVALUATION OF PT ESTABLISHED PLAN,4697164,CDM,424,RC,97164,HCPCS,outpatient,,,170,110.5,,113.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,153,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,47.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,136,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,127.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,48.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,144.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.51,161.5,
OT ORTHOTICS FIT AND TRAIN EA 15mins,4740002,CDM,430,RC,,,outpatient,,,65.7,42.71,,44.02,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.13,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,52.56,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.28,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.42,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,17.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.59,62.42,
OT ELECTRICAL STIMULATION (UNATTENDED),4740004,CDM,430,RC,,,outpatient,,,83,53.95,,55.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,74.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.22,78.85,
OT THERAPUTIC EXERCISES EA 15 MIN,4740005,CDM,430,RC,,,outpatient,,,130,84.5,,87.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.8,123.5,
OT ACTIVITIES OF DAILY LIVING EA 15 MIN,4740006,CDM,430,RC,,,outpatient,,,66.5,43.23,,44.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.8,63.18,
OT ELECTRICAL STIM EA 15 MIN ATTENDED,4740007,CDM,430,RC,,,outpatient,,,182,118.3,,121.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,132.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,163.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,145.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,136.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,172.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,154.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.72,172.9,
OT ULTRASOUND/PHONOPHERESIS  EA 15 MIN,4740010,CDM,430,RC,,,outpatient,,,105.5,68.58,,70.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,94.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,84.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,79.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,29.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,100.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,28.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,63.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.24,100.23,
OT PARAFFIN BATH,4740011,CDM,430,RC,,,outpatient,,,23.5,15.28,,15.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.29,22.33,
OT WHIRLPOOL,4740013,CDM,430,RC,,,outpatient,,,168.5,109.53,,112.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,151.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,46.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,134.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,126.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,143.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.11,160.08,
OT NEUROMUSCULAR REED EA 15MIN,4740015,CDM,430,RC,,,outpatient,,,140.5,91.33,,94.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.61,133.48,
OT ROM HAND,4740016,CDM,430,RC,,,outpatient,,,18.5,12.03,,12.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,16.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,14.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,13.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4.95,17.58,
OT MUSCLE TESTING MANUAL EXT/TRUNK,4740017,CDM,430,RC,,,outpatient,,,44,28.6,,29.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,39.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,35.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,33,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.78,41.8,
OT MUSCLE TESTING MANUAL HAND,4740018,CDM,430,RC,,,outpatient,,,46,29.9,,30.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,41.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.31,43.7,
OT APPLICATION OF FINGER SPLINT STATIC,4740019,CDM,430,RC,,,outpatient,,,51.5,33.48,,34.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.79,48.93,
OT CONTRAST BATH EA 15 MIN,4740020,CDM,430,RC,,,outpatient,,,50,32.5,,33.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.39,47.5,
OT ROM EXT/TRUNK,4740021,CDM,430,RC,,,outpatient,,,10,6.5,,6.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2.68,9.5,
OT PHYSICAL PERFORMANCE TEST EA 15 MIN,4740023,CDM,430,RC,,,outpatient,,,101,65.65,,67.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,90.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,80.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,75.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.04,95.95,
OT COGNITIVE SKILLS EA 15 MIN,4740024,CDM,430,RC,,,outpatient,,,88.5,57.53,,59.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,53.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.69,84.08,
OT SELECTIVE DEBRIDEMENT 1st 20cm,4740025,CDM,430,RC,,,outpatient,,,129.83,84.39,,86.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,116.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,103.86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.37,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.36,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,77.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.76,123.34,
OT PROSTHETIC TRAINING EA 15 MIN,4740028,CDM,430,RC,,,outpatient,,,50.5,32.83,,33.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.06,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,37.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.52,47.98,
OT VASOPENUMATIC DEVICE,4740029,CDM,430,RC,,,outpatient,,,54.5,35.43,,36.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,49.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.59,51.78,
OT IONTOPHORESIS EA 15 MIN,4740030,CDM,430,RC,,,outpatient,,,195.5,127.08,,130.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,175.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,156.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,146.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,185.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,166.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,117.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.34,185.73,
OT SENSORY INTEGRATIVE TECH EA 15 MIN,4740031,CDM,430,RC,,,outpatient,,,52.8,34.32,,35.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.52,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.6,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.16,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.13,50.16,
OT WHEELCHAIR MGMT EA 15 MIN,4740033,CDM,430,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
OT MASSAGE EA 15 MIN,4740034,CDM,430,RC,,,outpatient,,,45.5,29.58,,30.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,12.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,40.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,12.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,36.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,34.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,12.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,12.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,12.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,38.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,27.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,12.18,43.23,
OT STRAPPING; SHOULDER,4740036,CDM,430,RC,,,outpatient,,,91,59.15,,60.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.36,86.45,
OT GROUP,4740039,CDM,430,RC,,,outpatient,,,34.5,22.43,,23.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,31.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,27.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,9.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,29.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9.24,32.78,
OT THERAPEUCTIC ACT EA 15 MIN,4740040,CDM,430,RC,,,outpatient,,,76,49.4,,50.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,68.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,21.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,60.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,57,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.35,72.2,
OT MANUAL THERAPY TECH 15 MINS,4740060,CDM,430,RC,,,outpatient,,,263,170.95,,176.21,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,73.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,236.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,73.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,210.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,197.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.38,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,249.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,71.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,223.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.41,249.85,
OT NEGATIVE PRESS WOUND THERAPY <50cm,4740095,CDM,430,RC,,,outpatient,,,82,53.3,,54.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,73.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,65.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,61.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,69.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.95,77.9,
OT NEGATIVE PRESSURE WOUND THERAPY PUMP,4740096,CDM,430,RC,,,outpatient,,,131,85.15,,87.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,98.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,111.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.07,124.45,
OT G8978 MOBILITY CURRENT STATUS,4740103,CDM,430,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
OT G8979 MOBILITY GOAL STATUS,4740104,CDM,430,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
OT G8980 MOBILITY D/C STATUS,4740105,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8984 CARRYING CURRENT STATUS,4740106,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8985 CARRYING GOAL STATUS,4740107,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8986 CARRYING D/C STATUS,4740108,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8987 SELF CARE CURRENT STATUS,4740109,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8988 SELF CARE GOAL STATUS,4740110,CDM,430,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
OT G8989 SELF CARE D/C STATUS,4740111,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT APP MULTI-LAYER COMPRESSION UPPER EXT,4740112,CDM,430,RC,,,outpatient,,,99.05,64.38,,66.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.52,94.1,
OT SELECTIVE DEBRIDEMENT EA ADD'L 20cm,4740114,CDM,430,RC,,,outpatient,,,21,13.65,,14.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,18.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,16.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,15.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,5.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5.62,19.95,
OT NEGATIVE PRESS WOUND THERAPY >50cm,4740115,CDM,430,RC,,,outpatient,,,54,35.1,,36.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,48.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,43.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,40.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.27,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,51.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.46,51.3,
OT G8990 OTHER PT/OT CURRENT STATUS,4740116,CDM,430,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
OT G8991 OTHER PT/OT GOAL STATUS,4740117,CDM,430,RC,,,outpatient,,,0.5,0.33,,0.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.13,0.48,
OT G8992 OTHER PT/OT D/C STATUS,4740118,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8993 SUB PT/OT CURRENT STATUS,4740119,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8994 SUB PT/OT GOAL STATUS,4740120,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8995 SUB PT/OT D/C STATUS,4740121,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G9165 ATTEN CURRENT STATUS,4740122,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G9166 ATTEN GOAL STATUS,4740123,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G9167 ATTEN D/C STATUS,4740124,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G9168 MEMORY CURRENT STATUS,4740125,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G9169 MEMORY GOAL STATUS,4740126,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G9170 MEMORY D/C STATUS,4740127,CDM,430,RC,,,outpatient,,,0.09,0.06,,0.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.08,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.07,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.07,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.09,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.03,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.02,0.09,
OT G8981 BODY POS CURRENT STATUS,4740128,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8982 BODY POS GOAL STATUS,4740129,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT G8983 BODY POS D/C STATUS,4740130,CDM,430,RC,,,outpatient,,,0.9,0.59,,0.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,0.81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,0.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,0.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,0.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,0.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,0.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.86,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.77,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,0.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,0.24,0.86,
OT CIS EVALUATION LOW COMPLEXITY,4797003,CDM,430,RC,,,outpatient,,,319.5,207.68,,214.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,89.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,89.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,233.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,287.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,88.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,255.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,239.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,90.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,85.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,89.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,303.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,87.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,271.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,191.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.53,303.53,
OT CIS EVALUATION MODERATE COMPLEXITY,4797004,CDM,430,RC,,,outpatient,,,90,58.5,,60.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.09,85.5,
OT CIS EVALUATION HIGH COMPLEXITY,4797005,CDM,430,RC,,,outpatient,,,132.5,86.13,,88.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,119.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.47,125.88,
OT EVALUATION LOW COMPLEXITY,4797165,CDM,434,RC,,,outpatient,,,319.5,207.68,,214.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,89.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,89.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,233.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,287.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,88.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,255.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,239.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,90.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,85.53,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,89.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,303.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,87.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,271.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,191.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,85.53,303.53,
OT EVALUATION MODERATE COMPLEXITY,4797166,CDM,434,RC,,,outpatient,,,90,58.5,,60.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,67.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,85.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,76.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.09,85.5,
OT EVALUATION HIGH COMPLEXITY,4797167,CDM,434,RC,,,outpatient,,,132.5,86.13,,88.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,119.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,106,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,99.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,79.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.47,125.88,
OT RE-EVALUATION,4797168,CDM,434,RC,97004,HCPCS,outpatient,,,256.5,166.73,,171.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,71.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,187.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,230.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,71.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,205.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,192.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,72.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,68.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,70.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,218.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,153.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,153.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.67,243.68,
OT CIS  ACTIVITIES of DAILY LIVING EA 15,4797535,CDM,430,RC,,,outpatient,,,66.5,43.23,,44.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,59.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,18.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,53.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,49.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,18.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,17.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,56.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,17.8,63.18,
OT CIS WHEELCHAIR MANGMT PROP TRN 15 MIN,4797542,CDM,430,RC,,,outpatient,,,88,57.2,,58.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,79.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,70.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,66,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,74.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.03,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.56,83.6,
EVALUATION & MANAGEMENT LEVEL 1 (ED),4800001,CDM,450,RC,,,outpatient,,,257.5,167.38,,172.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,72.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,187.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,231.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,71.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,206,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,193.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,72.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,68.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,72.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,244.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,70.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,218.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,154.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,154.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.93,244.63,
EVALUATION & MANAGEMENT LEVEL 2 (ED),4800002,CDM,450,RC,93798,HCPCS,outpatient,,,113.5,73.78,,76.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,102.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,90.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,85.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.1,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,96.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,68.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.38,107.83,
EVALUATION & MANAGEMENT LEVEL 3 (ED),4800003,CDM,450,RC,,,outpatient,,,401.5,260.98,,269.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,112.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,112.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,293.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,361.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,111.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,321.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,301.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,113.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,107.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,112.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,381.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,109.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,341.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,240.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,240.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,107.48,381.43,
EVALUATION & MANAGEMENT LEVEL 4 (ED),4800004,CDM,450,RC,,,outpatient,,,1291,839.15,,864.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,361.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,345.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,361.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,942.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1161.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,359.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1032.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,968.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,365.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,345.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,361.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1226.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,352.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1097.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,774.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,774.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,352.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,345.6,1226.45,
EVALUATION & MANAGEMENT LEVEL 5 (ED),4800005,CDM,450,RC,,,outpatient,,,596.5,387.73,,399.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,167.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,159.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,167.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,435.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,536.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,166.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,477.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,447.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,168.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,159.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,167.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,566.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,162.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,507.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,357.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,167.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,357.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,159.68,566.68,
EVALUATION & MANAGEMENT CRITICAL CARE(ED,4800016,CDM,450,RC,,,outpatient,,,2954,1920.1,,1979.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,827.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,790.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,827.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2156.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2658.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,822.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2363.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2215.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,835.39,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,790.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,827.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2806.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,806.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2510.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1772.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,827.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1772.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,806.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,790.79,2806.3,
CRITICAL CARE @ ADD'L 30 MINS,4800017,CDM,450,RC,,,outpatient,,,178.5,116.03,,119.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,49.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,47.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,130.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,160.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,49.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,142.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,133.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,50.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,47.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,48.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,151.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.74,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.78,169.58,
SHOULDER (CLOSED TX) W MANIP W/ANESTHESI,4800020,CDM,450,RC,,,outpatient,,,3244,2108.6,,2173.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,908.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,868.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,908.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2368.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2919.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,903.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2595.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2433,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,917.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,868.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,908.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3081.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,885.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2757.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1946.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,908.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1946.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,885.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,868.42,3081.8,
ORBITOTOMY WO BONE FLAP W DRAINAGE,4800021,CDM,450,RC,,,outpatient,,,6203,4031.95,,4156.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1736.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1660.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1736.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4528.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5582.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1726.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4962.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4652.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1754.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1660.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1736.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5892.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1693.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5272.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3721.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1736.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3721.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1693.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1660.54,5892.85,
IVP EACH sequential same drug,4800037,CDM,450,RC,,,outpatient,,,190,123.5,,127.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,53.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,171,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,52.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,152,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,142.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,53.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,50.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,53.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,180.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,51.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,161.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,50.86,180.5,
IV INFUSION THERAPY @ ADD'L HR UP TO 8HR,4800038,CDM,450,RC,,,outpatient,,,156,101.4,,104.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,140.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,124.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,117,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,44.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,148.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,132.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.76,148.2,
IVP each sequential new drug,4800039,CDM,450,RC,,,outpatient,,,94.5,61.43,,63.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,75.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,70.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,56.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.3,89.78,
IV INFUSION FOR THERAPY UP TO 1hr,4800040,CDM,450,RC,,,outpatient,,,631.5,410.48,,423.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,176.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,461,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,568.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,175.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,505.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,473.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,178.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,169.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,176.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,599.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,172.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,536.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,378.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,378.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,172.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,169.05,599.93,
IV INF HYDRATION @ ADD'L HR UP TO 8 HRS,4800042,CDM,450,RC,,,outpatient,,,92,59.8,,61.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,82.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,73.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,69,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,78.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.63,87.4,
IV PUSH single or initial DRUG,4800043,CDM,450,RC,,,outpatient,,,248,161.2,,166.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,69.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,69.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,181.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,223.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,69.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,198.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,186,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,70.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,66.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,69.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,235.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,67.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,148.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,148.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,66.39,235.6,
IM SUB Q INJECTION EACH,4800044,CDM,450,RC,,,outpatient,,,240.5,156.33,,161.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,175.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,216.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,66.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,192.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,180.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,68.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,64.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,228.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,65.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,204.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,144.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.38,228.48,
IMMUNIZATION ADMIN 1ST VACCINE,4800045,CDM,771,RC,,,outpatient,,,136.5,88.73,,91.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,38.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,122.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,38,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,109.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,102.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,38.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,36.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,38.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,129.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,116.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,81.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.54,129.68,
"IV INFUSION, HYDRATION 1ST HR",4800048,CDM,450,RC,,,outpatient,,,348.5,226.53,,233.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,97.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,97.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,254.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,313.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,97.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,278.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,261.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,98.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,93.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,97.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,331.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,95.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,296.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,209.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,209.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,93.29,331.08,
VAGINAL DELIVERY ONLY,4800050,CDM,450,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
IMMUNIZATION ADMIN EACH ADDN'L VACCINE,4800051,CDM,771,RC,,,outpatient,,,51,33.15,,34.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,45.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,40.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.65,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.65,48.45,
SIMPLE 2.5CM OR LESS SCALP/NCK/AXIL/TRK/,4800055,CDM,450,RC,,,outpatient,,,378,245.7,,253.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,275.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,340.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,105.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,302.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,283.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,106.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,101.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,359.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,103.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,321.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,226.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,226.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,101.19,359.1,
SIMPLE 2.6CM-7.5CM SCALP/NCK/AXIL/TRK/EX,4800056,CDM,450,RC,,,outpatient,,,875.5,569.08,,586.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,245.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,245.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,639.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,787.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,243.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,700.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,656.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,247.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,234.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,245.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,831.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,239.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,744.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,525.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,245.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,525.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,239.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,234.37,831.73,
SIMPLE 7.6CM-12.5CM SCALP/NCK/AXIL/TRK/E,4800057,CDM,450,RC,,,outpatient,,,94.5,61.43,,63.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,75.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,70.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,56.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,56.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.81,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.3,89.78,
SIMPLE 12.6CM-20.0CM SCALP/NCK/AXIL/TRK/,4800058,CDM,450,RC,,,outpatient,,,283,183.95,,189.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,254.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,226.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,212.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.76,268.85,
SIMPLE 20.1CM-30.0CM SCALP/NCK/AXIL/TRK/,4800059,CDM,450,RC,,,outpatient,,,268.5,174.53,,179.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,75.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,75.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,196.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,241.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,74.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,214.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,201.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,75.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,71.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,75.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,73.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,228.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,161.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.88,255.08,
INTERVASCULAR CANNULIZATION OR SHUNT REV,4800061,CDM,450,RC,,,outpatient,,,8364,5436.6,,5603.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2341.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2239.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2341.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6105.72,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7527.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2328.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6691.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6273,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2365.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2239.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2341.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7945.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2283.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7109.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5018.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2341.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5018.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2283.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2239.04,7945.8,
"THROMBOLYSIS,CORONARY;BY IV INFUSION",4800062,CDM,450,RC,,,outpatient,,,532,345.8,,356.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,388.36,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,478.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,148.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,425.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,399,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,150.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,142.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,505.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,145.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,452.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,319.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,319.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,142.42,505.4,
"SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC",4800063,CDM,450,RC,,,outpatient,,,440.6,286.39,,295.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,123.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,321.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,396.54,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,122.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,352.48,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,330.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,124.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,117.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,418.57,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,120.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,374.51,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,264.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123.37,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,264.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.31,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,117.95,418.57,
THORACENTESIS W/INSERTION TUBE,4800066,CDM,450,RC,,,outpatient,,,1091.45,709.44,,731.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,305.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,292.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,305.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,796.76,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,982.31,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,303.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,873.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,818.59,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,308.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,292.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,305.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1036.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,298.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,927.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,654.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,305.61,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,654.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,298.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,292.18,1036.88,
CPR INTUBATION,4800067,CDM,450,RC,,,outpatient,,,237,154.05,,158.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,213.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,65.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,189.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,177.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,67.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,63.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,225.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,201.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,142.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,142.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.44,225.15,
"TRACHEOSTOMY, EMERGENCY PROCEDURE",4800068,CDM,450,RC,,,outpatient,,,407.5,264.88,,273.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,114.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,114.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,297.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,366.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,113.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,326,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,305.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,115.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,109.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,114.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,387.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,111.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,346.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,244.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,244.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,109.09,387.13,
"INTUBATION, ENDOTRACHEAL, EMERGENCY",4800069,CDM,450,RC,,,outpatient,,,183,118.95,,122.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,164.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,146.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,137.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.99,173.85,
CARDIOVERSION;EXTERNAL,4800075,CDM,450,RC,,,outpatient,,,1247.5,810.88,,835.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,349.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,333.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,349.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,910.68,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1122.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,347.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,998,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,935.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,352.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,333.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,349.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1185.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,340.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1060.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,748.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,349.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,748.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,340.64,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,333.96,1185.13,
TEMPORARY TRANSCUTANEOUS PACING,4800076,CDM,450,RC,,,outpatient,,,502,326.3,,336.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,140.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,366.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,451.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,139.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,401.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,376.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,141.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,134.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,476.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,137.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,426.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,301.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,301.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,134.39,476.9,
INCISION & DRAINAGE SIMPLE,4800078,CDM,450,RC,,,outpatient,,,162.5,105.63,,108.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,45.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,45.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,146.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,130,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,121.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,45.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,43.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,45.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,154.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,44.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,138.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,97.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.5,154.38,
INCISION & DRAINAGE COMPLICATED,4800079,CDM,450,RC,,,outpatient,,,222.5,144.63,,149.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,162.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,200.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,61.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,178,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,166.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,62.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,59.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,211.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,60.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,189.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,133.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,59.56,211.38,
INCISION & DRAINAGE HEMATOMA,4800080,CDM,450,RC,,,outpatient,,,102,66.3,,68.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,91.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,81.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.31,96.9,
INCISION & DRAINAGE PILONIDAL CYST SIMPL,4800081,CDM,450,RC,,,outpatient,,,426.28,277.08,,285.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,311.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,383.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,118.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,341.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,319.71,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,120.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,114.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,404.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,362.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,255.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.12,404.97,
INCISION & DRAINAGE PILONIDAL CYST COMPL,4800082,CDM,450,RC,,,outpatient,,,2265.5,1472.58,,1517.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1653.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2038.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,630.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1812.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1699.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,640.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2152.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1925.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,606.47,2152.23,
"AVULSION,NAIL PLATE, PART OR COMP,SIMPLE",4800083,CDM,450,RC,,,outpatient,,,102.5,66.63,,68.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,92.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,87.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.44,97.38,
REPAIR NAIL BED,4800084,CDM,450,RC,,,outpatient,,,355.31,230.95,,238.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,99.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,99.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,259.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,319.78,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,98.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,284.25,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,266.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,100.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,95.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,99.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,337.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,97.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,302.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,213.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.12,337.54,
EXCISION OF PILONIDAL CYST/SINUS;SIMPLE,4800085,CDM,450,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
EVACUATION OF SUBINGUAL HEMATOMA,4800086,CDM,450,RC,,,outpatient,,,38,24.7,,25.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,34.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,10.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,30.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,28.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,10.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,10.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,10.17,36.1,
"DEBRIDEMENT;SKIN, & SUBCUTANEOUS TISSUE",4800087,CDM,450,RC,,,outpatient,,,98.5,64.03,,66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.37,93.58,
INCISION & DRAINAGE BARTHOLIN'S GLAND AB,4800089,CDM,450,RC,,,outpatient,,,371.5,241.48,,248.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,271.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,334.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,103.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,297.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,278.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,105.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,99.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,352.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,101.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,315.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,222.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,222.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,99.45,352.93,
DEBRIDEMENT ECZEMATOUS OR INFECTED SKIN,4800090,CDM,450,RC,,,outpatient,,,75,48.75,,50.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,60,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,56.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.08,71.25,
INCISION & REMOVAL FOREIGN BODY SUB T SI,4800092,CDM,450,RC,,,outpatient,,,102,66.3,,68.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,91.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,81.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.31,96.9,
INCISION & REMOVAL FOREIGN BODY COMPLICA,4800093,CDM,450,RC,,,outpatient,,,114,74.1,,76.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,102.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,91.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,85.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,96.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.52,108.3,
"REMOVAL FOREIGN BODY,INTRANASAL",4800094,CDM,450,RC,,,outpatient,,,135.5,88.08,,90.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,121.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,108.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,101.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,38.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,36.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,115.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,81.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.27,128.73,
"FOREIGN BODY REMOVAL, EXTERNAL EYE",4800095,CDM,450,RC,,,outpatient,,,98,63.7,,65.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.23,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.23,93.1,
REMOVAL FOREIGN BODY EXTERNAL AUDITORY,4800096,CDM,450,RC,,,outpatient,,,58.5,38.03,,39.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,52.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,35.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.66,55.58,
"CONTROL NASAL HEMORRHAGE,ANTERIOR,SIMPLE",4800097,CDM,450,RC,,,outpatient,,,72,46.8,,48.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,64.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,57.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,54,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,61.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.27,68.4,
"DRAINAGE EXTERNAL EAR,ABCESS/HEMATOMA;SI",4800098,CDM,450,RC,,,outpatient,,,426.28,277.08,,285.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,119.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,311.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,383.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,118.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,341.02,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,319.71,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,120.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,114.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,119.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,404.97,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,116.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,362.34,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,255.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,114.12,404.97,
REMOVAL IMPACTED CERUMEN,4800099,CDM,450,RC,,,outpatient,,,42,27.3,,28.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,37.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,33.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,11.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.24,39.9,
CLOSED TREATMENT OF CARPAL SCAPHOID FX,4800100,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
CLOSED TX METACARPAL W/O MIN @ bone,4800101,CDM,450,RC,,,outpatient,,,338.5,220.03,,226.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,94.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,247.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,304.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,94.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,270.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,253.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,95.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,90.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,321.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,92.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,287.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,203.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,90.62,321.58,
SHOULDER (CLOSED TX) W/MANIP W/O ANESTHE,4800102,CDM,450,RC,,,outpatient,,,356,231.4,,238.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,99.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,99.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,259.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,320.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,99.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,284.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,267,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,100.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,95.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,99.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,338.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,97.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,302.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,213.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.3,338.2,
TREATMENT CLOSED ELBOW DISLOCATION W/O,4800103,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
APPLICATION OF LONG ARM SPLINT SH TO HAN,4800104,CDM,450,RC,,,outpatient,,,53,34.45,,35.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,38.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,47.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,42.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,39.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.19,50.35,
APPLICATION SHORT ARM SPLINT;STATIC,4800105,CDM,450,RC,,,outpatient,,,208,135.2,,139.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,58.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,55.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,151.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,187.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,57.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,166.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,156,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,58.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,55.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,58.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,197.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,56.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,176.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,55.68,197.6,
APPLICATION FINGER SPLINT; STATIC,4800106,CDM,450,RC,,,outpatient,,,51.5,33.48,,34.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,14.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,46.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,14.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,41.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,38.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,14.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,14.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,14.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,30.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.79,48.93,
APPLICATION LONG LEG SPLINT THIGH TO ANK,4800107,CDM,450,RC,,,outpatient,,,124,80.6,,83.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,34.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,111.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,34.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,99.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,93,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,35.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,33.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,117.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,105.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,74.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.19,117.8,
APPLICATION SHORT LEG SPLINT CALF TO FOO,4800108,CDM,450,RC,,,outpatient,,,266.5,173.23,,178.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,74.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,194.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,239.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,74.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,213.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,199.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,75.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,71.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,253.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,72.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,226.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,159.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,159.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.34,253.18,
INITIAL 1ST DEGREE,4800109,CDM,450,RC,,,outpatient,,,102.5,66.63,,68.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,92.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,87.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.44,97.38,
"DEBRIDEMENT, SMALL, W/O ANESTHESIA",4800110,CDM,450,RC,,,outpatient,,,201,130.65,,134.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,180.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,160.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,150.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.81,190.95,
DEBRIDEMENT MEDIUM W/O ANESTHESIA,4800111,CDM,450,RC,,,outpatient,,,335,217.75,,224.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,244.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,301.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,93.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,268,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,251.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,318.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,284.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.68,318.25,
SIMPLE 2.5CM OR LESS FACE/EAR/EYELD/LIPS,4800112,CDM,450,RC,,,outpatient,,,194.5,126.43,,130.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,54.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,175.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,155.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,145.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,184.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,165.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,116.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,116.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.07,184.78,
SIMPLE 2.6CM-5.0CM FACE/EAR/EYELD/LIPS,4800113,CDM,450,RC,,,outpatient,,,441,286.65,,295.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,123.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,321.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,396.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,122.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,352.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,330.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,124.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,118.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,418.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,120.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,374.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,264.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,264.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,118.06,418.95,
SIMPLE 5.1CM-7.5CM FACE/EAR/EYELD/LIPS,4800114,CDM,450,RC,,,outpatient,,,201,130.65,,134.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,180.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,160.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,150.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.81,190.95,
SIMPLE 7.6CM-12.5CM FACE/EAR/EYELD/LIPS,4800115,CDM,450,RC,,,outpatient,,,214,139.1,,143.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,59.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,59.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,192.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,59.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,171.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,160.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,60.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,57.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,59.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,58.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,181.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,57.29,203.3,
LAYER CLOSURE 2.5CM OR LESS SCALP/AXIL/E,4800116,CDM,450,RC,,,outpatient,,,746,484.9,,499.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,544.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,671.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,207.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,596.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,559.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,210.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,199.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,708.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,203.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,634.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,447.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,447.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,203.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,199.7,708.7,
LAYER CLOSURE 2.6CM-7.5CM SCALP/AXIL/EXT,4800117,CDM,450,RC,,,outpatient,,,233,151.45,,156.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,65.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,170.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,209.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,64.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,186.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,174.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,65.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,62.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,221.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,63.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,198.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,139.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,139.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.37,221.35,
LAYER CLOSURE 7.6CM-12.5CM SCALP/AXIL/EX,4800118,CDM,450,RC,,,outpatient,,,289,187.85,,193.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,260.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,231.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,274.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,245.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,173.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.37,274.55,
LAYER CLOSURE 12.6CM-20.0CM SCALP/AXIL/E,4800119,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
LAYER CLOSURE 2.5CM OR LESS NCK/HND/FEET,4800120,CDM,450,RC,,,outpatient,,,329,213.85,,220.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,92.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,240.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,296.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,91.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,263.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,246.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,93.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,88.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,312.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,89.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,279.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,197.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,197.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,88.07,312.55,
LAYER CLOSURE 2.6CM-7.5CM NCK/HND/FEET,4800121,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
LAYER CLOSURE 7.6CM-12.5CM NCK/HND/FEET,4800122,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
LAYER CLOSURE 12.6CM-20.0CM NCK/HND/FEET,4800123,CDM,450,RC,,,outpatient,,,1429.61,929.25,,957.84,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,400.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,382.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,400.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1043.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1286.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,398.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1143.69,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1072.21,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,404.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,382.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,400.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1358.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,390.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.17,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,857.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,400.29,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,857.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,382.71,1358.13,
LAYER CLOSURE 2.5CM OR LESS FCE/EAR/EYE,4800124,CDM,450,RC,,,outpatient,,,746,484.9,,499.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,544.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,671.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,207.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,596.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,559.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,210.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,199.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,708.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,203.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,634.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,447.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,447.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,203.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,199.7,708.7,
LAYER CLOSURE 2.6CM-5.0CM FCE/EAR/EYELD,4800125,CDM,450,RC,,,outpatient,,,240,156,,160.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,175.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,216,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,66.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,192,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,180,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,67.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,64.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,228,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,65.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,204,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.25,228,
LAYER CLOSURE 5.1CM-7.5CM FACE/EAR/EYELD,4800126,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
LAYER CLOSURE 7.5CM-12.5CM FACE/EAR/EYEL,4800127,CDM,450,RC,,,outpatient,,,274.5,178.43,,183.92,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,76.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,76.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,200.39,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,247.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,76.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,219.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,205.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,77.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,73.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,76.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,260.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,74.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,233.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,164.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.48,260.78,
COMPLEX 1.1CM-2.5CM TRUNK,4800128,CDM,450,RC,,,outpatient,,,1228.5,798.53,,823.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,896.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1105.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,342.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,982.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,921.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,347.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1167.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1044.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,328.87,1167.08,
COMPLEX 2.6CM-7.5CM TRUNK,4800129,CDM,450,RC,,,outpatient,,,1228.5,798.53,,823.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,896.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1105.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,342.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,982.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,921.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,347.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1167.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1044.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,328.87,1167.08,
COMPLEX 1.1CM-2.5CM SCALP/ARM/LEG,4800130,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
COMPLEX 2.5CM-7.5CM SCALP/ARM/LEG,4800131,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
COMPLEX 1.1CM-2.5CM FOREHD/CHK/CHIN/MOUT,4800132,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
COMPLEX 2.6CM-7.5CM FOREHD/CHK/CHIN/MOUT,4800133,CDM,450,RC,,,outpatient,,,1228.5,798.53,,823.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,896.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1105.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,342.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,982.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,921.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,347.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1167.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1044.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,328.87,1167.08,
CENTRAL VENOUS CATH UNDER AGE 5,4800134,CDM,450,RC,,,outpatient,,,2454.5,1595.43,,1644.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,657.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1791.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2209.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,683.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1963.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1840.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,694.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,657.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2331.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,670.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2086.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1472.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1472.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,670.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,657.07,2331.78,
CENTRAL VENOUS CATH AGE 5 OR OLDER,4800135,CDM,450,RC,,,outpatient,,,1968.6,1279.59,,1318.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,526.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1437.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1771.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,548.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1574.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1476.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,556.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,526.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1870.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,537.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1673.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1181.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1181.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,537.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,526.99,1870.17,
"GASTROSTOMY TUBE, REPOSITION",4800137,CDM,450,RC,,,outpatient,,,1946.5,1265.23,,1304.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,545.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,521.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,545.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1420.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1751.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,541.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1557.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1459.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,550.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,521.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,545.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1849.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,531.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1654.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1167.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,545.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1167.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,531.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,521.08,1849.18,
PUNCTURE ASPIRATION OF ABSCESS/HEMA/CYST,4800138,CDM,450,RC,,,outpatient,,,392,254.8,,262.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,352.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,109.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,313.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,294,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,110.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,104.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,372.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,107.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,333.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,235.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,235.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.94,372.4,
COMPLEX 2.6CM-7.5CM EYELD/NOSE/EAR/LIP,4800140,CDM,450,RC,,,outpatient,,,1228.5,798.53,,823.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,896.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1105.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,342.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,982.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,921.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,347.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1167.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1044.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,328.87,1167.08,
GASTRIC INTUBATION,4800141,CDM,450,RC,,,outpatient,,,114,74.1,,76.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,102.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,91.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,85.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,96.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.52,108.3,
"ARTHROCENTESIS,INTERMEDIATE JOINT",4800142,CDM,450,RC,,,outpatient,,,570.5,370.83,,382.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,513.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,158.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,456.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,427.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,161.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,541.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,484.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,152.72,541.98,
"INCISION OF THROMBOSED HEMORRHOID,EXTERN",4800143,CDM,450,RC,,,outpatient,,,134,87.1,,89.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,120.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,107.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,100.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,37.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,35.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,36.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,113.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,35.87,127.3,
ARTHROCENTESIS; MAJOR JOINT OR BURSA,4800144,CDM,450,RC,,,outpatient,,,57.5,37.38,,38.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.39,54.63,
"CONTROL NASAL HEMORRHAGE,ANTERIOR,COMPLE",4800145,CDM,450,RC,,,outpatient,,,244,158.6,,163.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,219.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,67.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,195.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,183,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,231.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,66.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,207.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,146.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.32,231.8,
CLOSED TX MEACARPOPHALANGEAL DISLOCATION,4800146,CDM,450,RC,,,outpatient,,,634.5,412.43,,425.12,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,177.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,177.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,463.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,571.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,176.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,507.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,475.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,179.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,169.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,177.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,602.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,173.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,539.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,380.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,380.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,169.86,602.78,
CLOSED TX MEACARPOPHALANGEAL DISLOCATION,4800147,CDM,450,RC,,,outpatient,,,966.36,628.13,,647.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,270.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,258.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,270.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,705.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,869.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,269.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,773.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,724.77,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,273.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,258.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,270.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,918.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,263.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,821.41,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,579.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,579.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,263.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,258.69,918.04,
"COLPORRHAPHY, SUTURE OF VAGINA (NON-OB)",4800148,CDM,450,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
VENTILATION ASSIST & MANAGEMENT,4800149,CDM,410,RC,,,outpatient,,,465,302.25,,311.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,130.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,124.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,339.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,418.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,129.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,372,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,348.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,131.5,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,124.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,441.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,126.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,395.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,279,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,279,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,124.48,441.75,
CLOSED TX METATARSOPHALANGEAL JOINT,4800150,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
"CLOSED TX CARPOMETACARPAL DISLOCATION,TH",4800151,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
EXCISION BENIGN LESION 1.1 T0 2.0 CM,4800153,CDM,450,RC,,,outpatient,,,160,104,,107.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,44.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,116.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,144,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,44.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,128,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,120,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,45.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,42.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,43.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,136,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.83,152,
COMPLEX 2.6CM-7.5CM TRUNK; @ add'l 5cm,4800154,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
WOUND CLOSURE BY ADHESIVE (DERMABOND),4800168,CDM,450,RC,,,outpatient,,,23.5,15.28,,15.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,21.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,17.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.29,22.33,
DEBRIDEMENT LARGE  W/O ANESTHESIA,4800169,CDM,450,RC,,,outpatient,,,325.5,211.58,,218.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,91.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,91.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,237.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,292.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,90.63,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,260.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,244.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,92.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,87.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,91.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,309.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,88.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,276.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,195.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,195.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,87.14,309.23,
"REMOVAL EMBEDDED F.B., EYELID",4800170,CDM,450,RC,,,outpatient,,,453,294.45,,303.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,126.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,121.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,126.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,330.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,407.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,126.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,362.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,339.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,128.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,121.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,126.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,430.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,123.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,385.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,271.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,271.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,121.27,430.35,
EXCISION EXTERNAL EAR;PARTIAL;SIMPLE,4800171,CDM,450,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
PERICARDIOCENTESIS; INITIAL,4800172,CDM,450,RC,,,outpatient,,,1287.5,836.88,,862.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,939.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1158.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,358.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1030,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,965.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,364.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1223.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1094.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,344.66,1223.13,
ANOSCOPY; DIAGNOSTIC,4800173,CDM,450,RC,,,outpatient,,,155.5,101.08,,104.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,139.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,124.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,116.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,132.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,93.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.63,147.73,
"REPAIR, PRIMARY, ACHILLES TENDON",4800174,CDM,450,RC,,,outpatient,,,10730.5,6974.83,,7189.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3004.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2872.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3004.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7833.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9657.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2987.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8584.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8047.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3034.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2872.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3004.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10193.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2930,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9120.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6438.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3004.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6438.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2930,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2872.55,10193.98,
I & D SCROTAL WALL ABSCESS,4800176,CDM,450,RC,,,outpatient,,,2265.5,1472.58,,1517.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1653.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2038.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,630.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1812.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1699.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,640.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2152.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1925.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,606.47,2152.23,
SIMPLE REPAIR OVER 30.0cm,4800178,CDM,450,RC,,,outpatient,,,186.5,121.23,,124.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,52.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,49.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,136.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,167.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,51.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,149.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,139.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,52.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,49.93,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,52.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,177.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,50.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,158.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,111.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.22,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,111.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,49.93,177.18,
CHEMICAL CAUTERY TISSUE,4800179,CDM,450,RC,,,outpatient,,,84,54.6,,56.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,67.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.49,79.8,
"FOREIGN BODY REMOVAL, EXTERNAL EYE,CORNE",4800195,CDM,450,RC,,,outpatient,,,80,52,,53.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,22.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,60,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,22.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,21.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,76,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,21.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,21.42,76,
"REMOVAL OF FOREIGN BODY, FOOT;SUBCUTANEO",4800196,CDM,450,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
INCISION & DRAINAGE PERIANAL ABSCESS,4800197,CDM,450,RC,,,outpatient,,,1372,891.8,,919.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1001.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1234.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,381.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1097.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1029,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,388,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,367.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1303.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,374.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1166.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,823.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,823.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,374.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,367.28,1303.4,
ARTERIAL CATHETERIZATION OR CANNULATION,4800198,CDM,450,RC,,,outpatient,,,124.5,80.93,,83.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,34.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,112.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,34.66,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,99.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,93.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,35.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,33.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,34.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,105.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,74.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,33.33,118.28,
"APPLICATION,CAST,ELBOW TO FINGER",4800199,CDM,450,RC,,,outpatient,,,87,56.55,,58.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,63.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,78.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,24.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,69.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,65.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,24.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,23.29,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,23.29,82.65,
INJECTION SINGLE OR MULT TRIGGER POINTS,4800200,CDM,450,RC,,,outpatient,,,570.5,370.83,,382.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,513.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,158.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,456.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,427.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,161.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,541.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,484.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,152.72,541.98,
STRAPPING; UNNA BOOT,4800201,CDM,450,RC,,,outpatient,,,107.5,69.88,,72.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,30.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,28.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,96.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,29.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,86,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,80.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,30.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,28.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,30.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,29.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,91.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,64.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.78,102.13,
REMOVAL FOREIGN OBJECT FROM PHARYNX,4800202,CDM,450,RC,,,outpatient,,,256.18,166.52,,171.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,71.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,187.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,230.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,71.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,204.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,192.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,72.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,68.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,69.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,217.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,153.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,153.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.58,243.37,
"I & D OF EPIDIDYMIS,TESTIS &/OR SCROTAL",4800204,CDM,450,RC,,,outpatient,,,3115.8,2025.27,,2087.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,834.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2274.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2804.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,867.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2492.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2336.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,881.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,834.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2960.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,850.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2648.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1869.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1869.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,850.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,834.1,2960.01,
CLOSED TX FX PHALANX W/MANIPULATION,4800205,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
CATHETER NON-INDWELLING (STRAIGHT CATH),4800207,CDM,450,RC,,,outpatient,,,33.5,21.78,,22.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,9.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,30.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,9.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,26.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,25.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,9.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,8.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,9.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,9.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,28.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8.97,31.83,
CATHETER INDWELLING SIMPLE,4800208,CDM,450,RC,,,outpatient,,,56,36.4,,37.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,44.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,14.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,47.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,14.99,53.2,
CLOSED TX RADIAL HEAD SUBLUXATION,4800209,CDM,450,RC,,,outpatient,,,97.5,63.38,,65.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,87.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,92.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,82.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,58.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,58.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.1,92.63,
CLOSED TX CARPOMETACARPA DX W/O ANESTHES,4800210,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
INCISION & DRAINAGE UPPER ARM/ELBOW,4800211,CDM,450,RC,,,outpatient,,,4118,2676.7,,2759.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1102.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3006.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3706.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1146.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3294.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3088.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1164.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1102.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3912.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1124.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3500.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2470.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2470.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1124.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1102.39,3912.1,
CLOSED TX OF PATELLAR DISLOCATION W/O AN,4800212,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
COMPLEX 1.1CM-2.5CM EYELD/NOSE/EAR/LIP,4800213,CDM,450,RC,,,outpatient,,,1228.5,798.53,,823.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,896.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1105.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,342.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,982.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,921.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,347.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1167.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1044.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,328.87,1167.08,
"ARTHROCENTESIS, SMALL JOINT(FING/TOES)",4800214,CDM,450,RC,,,outpatient,,,570.5,370.83,,382.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,513.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,158.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,456.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,427.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,161.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,541.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,484.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,152.72,541.98,
CLOSED TX INTERPHALANGEAL JOINT DISLOCAT,4800215,CDM,450,RC,,,outpatient,,,197,128.05,,131.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,55.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,143.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,177.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,157.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,147.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,187.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,167.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.74,187.15,
"AVULSION,NAIL PLATE, EA ADD'L",4800216,CDM,450,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
"VENIPUNCTURE, CUTDOWN; < 1 YEAR",4801134,CDM,450,RC,,,outpatient,,,73.5,47.78,,49.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,19.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,66.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,58.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,55.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,20.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,19.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,44.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.68,69.83,
"VENIPUNCTURE, CUTDOWN; > 1 YEAR",4801135,CDM,450,RC,,,outpatient,,,256.18,166.52,,171.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,71.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,187.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,230.56,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,71.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,204.94,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,192.14,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,72.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,68.58,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.37,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,69.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,217.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,153.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,153.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.58,243.37,
FINE NEEDLE ASPIRATN; W/O IMAG GUID,4810021,CDM,450,RC,,,outpatient,,,368,239.2,,246.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,331.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,102.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,294.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,276,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,104.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,98.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,349.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,100.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,312.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,220.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,220.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,98.51,349.6,
PARING OR CUTTING BENIGN LESION; SINGLE,4811055,CDM,450,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
BIOPSY W/SIMPLE CLOSURE; SINGLE LESION,4811100,CDM,450,RC,,,outpatient,,,95,61.75,,63.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,71.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.43,90.25,
EXCISION BENIGN LESION 0.5cm OR LESS,4811420,CDM,450,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
EXCISION BENIGN LESION 1.1cm TO 2.0cm,4811422,CDM,450,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
DEBRIDEMENT NAIL 1-5,4811720,CDM,450,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
EXCISION OF NAIL & NAIL MATRIX; PART/COM,4811750,CDM,450,RC,,,outpatient,,,1051,683.15,,704.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,767.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,945.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,292.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,840.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,788.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,297.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,998.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,893.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,281.35,998.45,
REPAIR INTERMEDIATE 20.1CM TO 30.0CM,4812036,CDM,450,RC,,,outpatient,,,1338.5,870.03,,896.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,374.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,358.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,374.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,977.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1204.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,372.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1070.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1003.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,378.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,358.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,374.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1271.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,365.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1137.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,803.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,374.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,803.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,365.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,358.32,1271.58,
REPAIR INTERMEDIATE NCK HND FT 12.6cm,4812055,CDM,450,RC,,,outpatient,,,622.5,404.63,,417.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,174.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,166.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,174.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,454.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,560.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,173.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,498,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,466.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,176.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,166.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,174.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,591.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,169.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,529.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,373.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,373.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,166.64,591.38,
COMPLEX 2.5CM-7.5CM SCALP/ARM/LEG,4813122,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
COMPLEX REPAIR EA ADD'L 5cm,4813133,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
REPAIR COMPLEX @ ADD'L 5cm OR LESS,4813153,CDM,450,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
SURG PREP RECIP SITE 1ST 100sq cm,4815004,CDM,450,RC,,,outpatient,,,1278.5,831.03,,856.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,357.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,357.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,933.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1150.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,355.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1022.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,958.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,361.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,342.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,357.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1214.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,349.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1086.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,767.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,767.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,349.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,342.25,1214.58,
SPLIT THICK AUTO GRAFT TRK ARM LEGS,4815100,CDM,450,RC,,,outpatient,,,7055.5,4586.08,,4727.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1975.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1888.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1975.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5150.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6349.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1964.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5644.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5291.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1995.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1888.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1975.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6702.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1926.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5997.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4233.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1975.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4233.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1926.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1888.76,6702.73,
SPLIT THICK AUTO GRAFT TRK ARM LEGS,4815101,CDM,450,RC,,,outpatient,,,7055.5,4586.08,,4727.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1975.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1888.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1975.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5150.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6349.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1964.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5644.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5291.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1995.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1888.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1975.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6702.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1926.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5997.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4233.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1975.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4233.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1926.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1888.76,6702.73,
"EXCISION, EXCESS SKIN; OTHER AREA",4815839,CDM,450,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
"MASTOTOMY W/EXPLORATION ABSCESS,DEEP",4819020,CDM,450,RC,,,outpatient,,,267,173.55,,178.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,74.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,194.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,240.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,74.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,213.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,200.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,75.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,71.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,253.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,72.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,226.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,160.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.48,253.65,
INCISION AND DRAINAGE SOFT TISS SUBFASC,4820005,CDM,450,RC,,,outpatient,,,467,303.55,,312.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,130.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,340.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,420.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,130.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,373.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,350.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,132.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,125.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,443.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,127.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,396.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,280.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,280.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,125.02,443.65,
EXPLORATION PENETRATING WOUND EXTREMITY,4820103,CDM,450,RC,,,outpatient,,,2265.5,1472.58,,1517.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1653.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2038.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,630.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1812.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1699.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,640.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2152.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1925.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,606.47,2152.23,
"INJECTION SINGLE TENDON SHEATH, LIG,APON",4820550,CDM,450,RC,,,outpatient,,,570.5,370.83,,382.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,513.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,158.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,456.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,427.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,161.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,541.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,484.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,152.72,541.98,
REPLANTATION DIGIT EXCL THUMB,4820822,CDM,450,RC,,,outpatient,,,6956.5,4521.73,,4660.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1947.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1862.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1947.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5078.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6260.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1936.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5565.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5217.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1967.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1862.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1947.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6608.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1899.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5913.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4173.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1947.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4173.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1899.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1862.26,6608.68,
EXCISION TUMOR SOFT TSS FACE/SCALP SQ 2+,4821011,CDM,360,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
CLOSED TX NASAL BONE FX W/O STABILIZATIO,4821315,CDM,450,RC,,,outpatient,,,5047,3280.55,,3381.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1413.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1351.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1413.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3684.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4542.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1405.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4037.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3785.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1427.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1351.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1413.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4794.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1378.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4289.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3028.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1413.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3028.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1378.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1351.08,4794.65,
CLOSED TX TEMPOROMANDIBULAR DISLOCAT,4821480,CDM,450,RC,,,outpatient,,,244,158.6,,163.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,219.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,67.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,195.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,183,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,231.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,66.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,207.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,146.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.32,231.8,
CLOSED TX CLAVICULAR FX W/O MANIPULATION,4823500,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
CLOSED TX ACROMIOCLAVICULAR DISLOCATION,4823545,CDM,450,RC,,,outpatient,,,378,245.7,,253.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,275.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,340.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,105.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,302.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,283.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,106.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,101.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,359.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,103.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,321.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,226.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,226.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,101.19,359.1,
CLOSED TX PROXIMAL HUMERAL W/MAN W/W/O T,4823605,CDM,450,RC,,,outpatient,,,2608.5,1695.53,,1747.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,730.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,698.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,730.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1904.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2347.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,726.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2086.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1956.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,737.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,698.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,730.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2478.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,712.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2217.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1565.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,730.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1565.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,712.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,698.3,2478.08,
CLOSED TX ULNAR FX PROXIMAL W/O MANIP,4824670,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
"ARTHROTOMY, WRIST JOINT W/EXPLORATION",4825101,CDM,450,RC,,,outpatient,,,7200.5,4680.33,,4824.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2016.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1927.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2016.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5256.37,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6480.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2004.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5760.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5400.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2036.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1927.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2016.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6840.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1966.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6120.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4320.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2016.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4320.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1966.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1927.57,6840.48,
CLOSED TX ULNAR SHAFT FX W/O MANIPULATIO,4825530,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
CLOSED TX DISTAL RADIAL FX,4825600,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
"CLOSED TX DISTAL RAD FX, W/MANIPULATION",4825605,CDM,450,RC,,,outpatient,,,1245.5,809.58,,834.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,348.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,333.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,348.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,909.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1120.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,346.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,996.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,934.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,352.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,333.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,348.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1183.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,340.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1058.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,747.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,747.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,340.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,333.42,1183.23,
DRAINAGE FINGER ABSCESS; SIMPLE,4826010,CDM,450,RC,,,outpatient,,,235.2,152.88,,157.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,65.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,171.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,211.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,65.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,188.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,176.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,66.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,62.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,223.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,199.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,141.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.96,223.44,
DRAINAGE OF FINGER ABSCESS; COMPLICATED,4826011,CDM,450,RC,,,outpatient,,,283,183.95,,189.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,254.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,226.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,212.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.76,268.85,
"REPAIR, EXT TENDON, FINGER",4826418,CDM,450,RC,,,outpatient,,,3701,2405.65,,2479.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2701.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3330.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1030.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2960.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2775.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1046.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3515.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3145.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,990.76,3515.95,
CLOSED TX METACARPAL FX W/MANIPULATION @,4826605,CDM,450,RC,,,outpatient,,,338.5,220.03,,226.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,94.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,247.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,304.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,94.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,270.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,253.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,95.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,90.62,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,94.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,321.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,92.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,287.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,203.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.78,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,203.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,90.62,321.58,
CLOSED TX PHALANGEAL SHAFT FX,4826720,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
CLOSED TX PHALANGEAL SHAFT FX W/MANI,4826725,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
CLOSED TX INTERPHALANGEAL JOINT W ANEST,4826775,CDM,450,RC,,,outpatient,,,690,448.5,,462.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,193.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,184.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,193.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,503.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,621,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,192.1,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,552,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,517.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,195.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,184.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,193.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,655.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,188.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,586.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,414,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,193.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,414,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,184.71,655.5,
"CLOSED TX FEMORAL FX, DISTAL END, NECK",4827230,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
"I & D DEEP ABCESS, BURSA, THIGH OR KNEE",4827301,CDM,450,RC,,,outpatient,,,4118,2676.7,,2759.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1102.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3006.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3706.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1146.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3294.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3088.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1164.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1102.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3912.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1124.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3500.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2470.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2470.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1124.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1102.39,3912.1,
CLOSED TX DISTAL FIB FX W/O MANIPULATION,4827786,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
CLOSED TX FX DISTAL TIBIA W/O MANIPULATI,4827825,CDM,450,RC,,,outpatient,,,2608.5,1695.53,,1747.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,730.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,698.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,730.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1904.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2347.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,726.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2086.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1956.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,737.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,698.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,730.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2478.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,712.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2217.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1565.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,730.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1565.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,712.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,698.3,2478.08,
ARTHROTOMY INTERPHALANGEAL JOINT,4828024,CDM,450,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
"EXCISION, INTERDIGITAL NEUROMA",4828080,CDM,450,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
"REMOVAL F.B.,FOOT; SUBCUTANEOUS",4828190,CDM,450,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
REMOVAL FB FOOT DEEP,4828192,CDM,450,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
CLOSED TX TALUX FX W/MANIPULATION,4828435,CDM,450,RC,,,outpatient,,,966.36,628.13,,647.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,270.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,258.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,270.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,705.44,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,869.72,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,269.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,773.09,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,724.77,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,273.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,258.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,270.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,918.04,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,263.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,821.41,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,579.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,579.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,263.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,258.69,918.04,
CLOSED TX INTERPHALANGEAL JOINT DISLOC,4828660,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
CLOSED TX INTERPHALANGEAL JOINT DISLOC,4828665,CDM,450,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
APPLICATION CAST FIGURE OF EIGHT,4829049,CDM,450,RC,,,outpatient,,,314.5,204.43,,210.72,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,88.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,88.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,229.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,283.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,87.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,251.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,235.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,88.94,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,84.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,88.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,298.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,85.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,267.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,188.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,188.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.87,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.19,298.78,
APPLICATION CAST HAND & LOWER FOREARM,4829085,CDM,450,RC,,,outpatient,,,296,192.4,,198.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,82.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,216.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,266.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,82.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,236.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,222,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,79.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,80.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,251.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.24,281.2,
APPLICATION SHORT ARM SPLINT; DYNAMIC,4829126,CDM,450,RC,,,outpatient,,,262,170.3,,175.54,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,73.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,191.26,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,235.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,72.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,209.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,196.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.09,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,73.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,248.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,71.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,222.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.14,248.9,
APPLICATION FINGER SPLINT; DYNAMIC,4829131,CDM,450,RC,,,outpatient,,,42.5,27.63,,28.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,31.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,38.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,11.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,34,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,31.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,12.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,11.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,40.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,11.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,25.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11.38,40.38,
STRAPPING; THORAX,4829200,CDM,450,RC,,,outpatient,,,169.5,110.18,,113.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,152.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,47.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,135.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,127.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,144.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.38,161.03,
STRAPPING; SHOULDER,4829240,CDM,450,RC,29240,HCPCS,outpatient,,,91,59.15,,60.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,66.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,81.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,25.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,72.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,68.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,25.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,24.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,24.36,86.45,
STRAPPING; ELBOW OR WRIST,4829260,CDM,450,RC,29260,HCPCS,outpatient,,,169.5,110.18,,113.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,152.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,47.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,135.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,127.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,144.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.38,161.03,
STRAPPING; HAND OR FINGER,4829280,CDM,450,RC,29280,HCPCS,outpatient,,,169.5,110.18,,113.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,152.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,47.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,135.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,127.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,144.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.38,161.03,
APPLICATION SHORT LEG CAST,4829405,CDM,450,RC,,,outpatient,,,114,74.1,,76.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,102.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,91.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,85.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,96.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.52,108.3,
STRAPPING; KNEE,4829530,CDM,450,RC,,,outpatient,,,112.5,73.13,,75.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,101.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.32,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,90,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,84.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,31.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,67.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.12,106.88,
STRAPPING; ANKLE AND/OR FOOT,4829540,CDM,450,RC,,,outpatient,,,99.05,64.38,,66.36,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,89.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,79.24,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,74.29,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,84.19,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.73,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.52,94.1,
STRAPPING; TOES,4829550,CDM,450,RC,,,outpatient,,,169.5,110.18,,113.57,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,152.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,47.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,135.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,127.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,144.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.38,161.03,
UNLISTED CASTING OR STRAPPING PROCEDURE,4829799,CDM,450,RC,,,outpatient,,,296,192.4,,198.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,82.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,216.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,266.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,82.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,236.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,222,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,83.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,79.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,82.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,80.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,251.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,79.24,281.2,
"CONTROL NASAL HEMORRHAGE, POSTERIOR",4830905,CDM,450,RC,,,outpatient,,,153.5,99.78,,102.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,42.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,138.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,42.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,122.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,115.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,42.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,145.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,41.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,130.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,92.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,92.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.09,145.83,
TRACH TUBE CHANGE,4831502,CDM,450,RC,,,outpatient,,,165,107.25,,110.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,148.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,132,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,123.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,46.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,44.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,156.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,140.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.05,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,44.17,156.75,
LARYNGOSCOPY INDIRECT DIAGNOSITC,4831525,CDM,450,RC,,,outpatient,,,4292,2789.8,,2875.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1201.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1148.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1201.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3133.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3862.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1194.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3433.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3219,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1213.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1148.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1201.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4077.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1171.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3648.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2575.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1201.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2575.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1171.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1148.97,4077.4,
THORACOSTOMY (CHEST TUBE),4832020,CDM,450,RC,,,outpatient,,,1287.5,836.88,,862.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,939.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1158.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,358.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1030,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,965.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,364.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1223.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1094.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,344.66,1223.13,
REPAIR BLOOD VESSEL DIRECT HAND FINGER,4835207,CDM,450,RC,,,outpatient,,,7368.5,4789.53,,4936.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2063.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1972.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2063.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5379.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6631.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2051.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5894.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5526.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2083.81,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1972.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2063.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7000.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2012,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6263.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4421.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2063.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4421.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2012,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1972.55,7000.08,
"REPAIR BLOOD VESSEL, LOWER EXTREMITY",4835226,CDM,450,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
ER TRANSFUSION BLOOD OR BLOOD COMPONENTS,4836430,CDM,391,RC,,,outpatient,,,198.5,129.03,,133,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,55.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,178.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,158.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,148.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,188.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,168.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,119.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,119.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.14,188.58,
REPAIR CV ACCESS DEVICE,4836576,CDM,450,RC,,,outpatient,,,2454.5,1595.43,,1644.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,657.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1791.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2209.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,683.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1963.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1840.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,694.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,657.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2331.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,670.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2086.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1472.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1472.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,670.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,657.07,2331.78,
PLACEMENT OF NEEDLE INTRAOSSEOUS INFUSIO,4836680,CDM,450,RC,,,outpatient,,,384,249.6,,257.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,107.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,107.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,280.32,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,345.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,106.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,307.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,288,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,108.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,102.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,107.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,364.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,104.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,326.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102.8,364.8,
THROMBOLYSIS CEREBRAL BY IV INFUSION,4837195,CDM,450,RC,,,outpatient,,,130,84.5,,87.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,117,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,36.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,104,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,97.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,36.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,34.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,110.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,34.8,123.5,
"TRANSCATHETER THERAPY, INFUSION THROMBOL",4837201,CDM,450,RC,,,outpatient,,,3220.24,2093.16,,2157.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,901.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,862.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,901.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2350.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2898.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,896.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2576.19,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2415.18,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,910.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,862.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,901.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3059.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,879.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2737.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1932.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,901.67,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1932.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,879.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,862.06,3059.23,
"REPAIR LAC 2.5cm OR LESS, MOUTH",4841250,CDM,450,RC,,,outpatient,,,244,158.6,,163.48,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,65.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,178.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,219.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,67.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,195.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,183,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,65.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,231.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,66.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,207.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,146.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,65.32,231.8,
REPAIR LAC TONGUE OVER 2.6CM,4841252,CDM,450,RC,,,outpatient,,,1557,1012.05,,1043.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,435.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1136.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1401.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,433.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1245.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1167.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,440.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,416.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1479.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,425.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,934.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,435.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,934.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,425.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,416.81,1479.15,
"DRAINAGE ABSCESS,CYST,HEMATOMA DENTOALV",4841800,CDM,450,RC,,,outpatient,,,182.5,118.63,,122.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,51.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,164.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,146,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,136.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,51.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,51.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,155.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,109.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,109.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.86,173.38,
"DRAINAGE OF ABSCESS OF PALATE, UVULA",4842000,CDM,450,RC,,,outpatient,,,717.5,466.38,,480.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,200.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,192.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,200.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,523.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,645.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,199.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,574,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,538.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,202.91,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,192.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,200.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,681.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,195.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,609.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,430.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,430.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,192.07,681.63,
"GASTROSTOMY, OPEN; W/O CONSTRUCT G TUBE",4843830,CDM,450,RC,,,outpatient,,,5829.5,3789.18,,3905.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1632.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1560.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1632.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4255.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5246.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1622.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4663.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4372.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1648.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1560.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1632.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5538.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1591.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4955.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3497.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1632.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3497.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1591.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1560.56,5538.03,
INCISION & DRAINAGE SUBMUCOSAL ABSCESS,4845005,CDM,450,RC,,,outpatient,,,4433,2881.45,,2970.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1241.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1186.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1241.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3236.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3989.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1234.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3546.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3324.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1253.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1186.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1241.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4211.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1210.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3768.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2659.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1241.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2659.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1210.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1186.71,4211.35,
INCISION & DRAINAGE SUPRALEVATOR PELVI,4845020,CDM,450,RC,,,outpatient,,,4433,2881.45,,2970.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1241.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1186.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1241.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3236.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3989.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1234.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3546.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3324.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1253.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1186.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1241.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4211.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1210.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3768.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2659.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1241.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2659.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1210.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1186.71,4211.35,
I & D  ISCHIORECTAL/PERIRECTAL ABSCESS,4846040,CDM,450,RC,,,outpatient,,,400,260,,268,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,112,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,112,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,292,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,360,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,111.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,320,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,300,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,113.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,107.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,112,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,380,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,109.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,340,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,240,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,240,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,107.08,380,
"INJECTION SCLEROSING SOLUT, HEMMORRHOID",4846500,CDM,450,RC,,,outpatient,,,1372,891.8,,919.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1001.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1234.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,381.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1097.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1029,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,388,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,367.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1303.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,374.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1166.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,823.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,823.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,374.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,367.28,1303.4,
ABDOMINAL PARACENTESIS W/O IMAGING GUIDA,4849082,CDM,450,RC,,,outpatient,,,1287.5,836.88,,862.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,939.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1158.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,358.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1030,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,965.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,364.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1223.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1094.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,344.66,1223.13,
"SUTURE, SEC, ABD WALL FOR EVIS/DEHIS",4849900,CDM,450,RC,,,outpatient,,,1546.5,1005.23,,1036.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,433.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,414,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,433.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1128.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1391.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,430.56,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1237.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1159.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,437.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,414,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,433.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1469.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,422.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1314.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,927.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,433.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,927.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,422.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,414,1469.18,
"BLADDER IRRIGATION;SIMPLE,LAVAGE &or INS",4851700,CDM,450,RC,,,outpatient,,,477.5,310.38,,319.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,348.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,429.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,132.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,382,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,358.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,135.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,127.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,453.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,130.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,405.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,286.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,127.83,453.63,
CATHETER INDWELLING COMPLICATED,4851703,CDM,450,RC,,,outpatient,,,256.5,166.73,,171.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,71.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,187.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,230.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,71.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,205.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,192.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,72.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,68.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,71.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,243.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,70.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,218.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,153.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,153.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,68.67,243.68,
"SLITTING OF PREPUCE,DORSAL OR LAT;EXC NB",4854001,CDM,450,RC,,,outpatient,,,4807.5,3124.88,,3221.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1286.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3509.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4326.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1338.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3846,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3605.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1359.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1286.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4567.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1312.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4086.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2884.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2884.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1312.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1286.97,4567.13,
INCISION & DRAINAGE OF EPIDIDYMIS TEST,4854700,CDM,450,RC,,,outpatient,,,3115.8,2025.27,,2087.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,834.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2274.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2804.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,867.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2492.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2336.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,881.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,834.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2960.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,850.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2648.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1869.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,872.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1869.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,850.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,834.1,2960.01,
INCISION & DRAINAGE VULVA/PERIANAL ABS,4856405,CDM,450,RC,,,outpatient,,,146,94.9,,97.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,39.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,106.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,131.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,40.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,116.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,109.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,41.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,39.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,138.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,39.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,124.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,39.08,138.7,
MARSUPIALIZATION BATRTHOLIN'S GLAND CYST,4856440,CDM,450,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
EXCISION BARTHOLIN'S GLAND OR CYST,4856740,CDM,450,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
EPISIOTOMY OR VAG REPAIR NOT ATTENDING,4859300,CDM,450,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
VAGINAL DELIVERY ONLY AFTER PREV C-SECT,4859612,CDM,450,RC,,,outpatient,,,4314,2804.1,,2890.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1207.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1154.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1207.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3149.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3882.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1201.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3451.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3235.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1220,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1154.86,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1207.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4098.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1177.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3666.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2588.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1207.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2588.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1177.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1154.86,4098.3,
CERVICAL PUNCTURE W MED INJECTION,4861055,CDM,450,RC,,,outpatient,,,2098.5,1364.03,,1406,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,587.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,561.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,587.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1531.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1888.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,584.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1678.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1573.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,593.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,561.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,587.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1993.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,573.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1783.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1259.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,587.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1259.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,573.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,561.77,1993.58,
"INJECTION SINGLE LUMBAR,SACRAL",4862311,CDM,450,RC,,,outpatient,,,1766,1147.9,,1183.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,494.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,472.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,494.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1289.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1589.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,491.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1412.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1324.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,499.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,472.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,494.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1677.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,482.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1501.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1059.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,494.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1059.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,482.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,472.76,1677.7,
"INJECTION ANESTHETIC AGENT, FACIAL NERV",4864402,CDM,450,RC,,,outpatient,,,570.5,370.83,,382.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,513.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,158.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,456.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,427.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,161.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,541.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,484.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,152.72,541.98,
INJECTION PERIPHERAL NERVE,4864450,CDM,450,RC,,,outpatient,,,1658.02,1077.71,,1110.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,464.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,443.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,464.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1210.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1492.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,461.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1326.42,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1243.52,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,468.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,443.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,464.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1575.12,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,452.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1409.32,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,994.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,464.25,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,994.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,452.73,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,443.85,1575.12,
"DRAINAGE OF ABSCESS, EYELID",4867700,CDM,450,RC,,,outpatient,,,723.5,470.28,,484.75,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,202.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,193.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,202.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,528.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,651.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,201.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,578.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,542.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,204.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,193.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,202.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,687.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,197.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,614.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,434.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,434.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,193.68,687.33,
SIMPLE 12.6CM-20.0CM FACE/EAR/EYELD/NOSE,4880060,CDM,450,RC,,,outpatient,,,268.5,174.53,,179.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,75.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,75.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,196.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,241.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,74.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,214.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,201.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,75.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,71.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,75.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,255.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,73.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,228.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,161.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.32,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.88,255.08,
RABIES VAC IM,4890675,CDM,450,RC,,,outpatient,,,602,391.3,,403.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,168.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,161.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,168.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,439.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,541.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,167.61,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,481.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,451.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,170.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,161.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,168.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,571.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,164.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,511.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,161.16,571.9,
INTRAVENOUS INFUSION; ADD'L SEQ TO 1 HR,4890767,CDM,450,RC,,,outpatient,,,49,31.85,,32.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,35.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,44.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,13.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,39.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,36.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,13.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,13.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13.12,46.55,
IV INFUSION; CONCURRENT INFUSION,4896368,CDM,450,RC,,,outpatient,,,24.5,15.93,,16.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,17.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,22.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,19.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,18.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,23.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.56,23.28,
IRRIGATION IMPLANTED VENOUS ACCESS DEVIC,4896523,CDM,450,RC,96523,HCPCS,outpatient,,,83.4,54.21,,55.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,23.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,22.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,75.06,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,23.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,66.72,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,62.55,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,23.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,22.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,23.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,79.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,22.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.89,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,50.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.35,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,50.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,22.33,79.23,
SHOULDER (CLOSED TX) W/MANIP W/ANESTHESI,4900002,CDM,981,RC,,,outpatient,,,3244,2108.6,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EMERGENCY DEPT PHYSICIAN LEVEL 1,4900011,CDM,981,RC,,,outpatient,,,257.5,167.38,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EMERGENCY DEPT PHYSICIAN LEVEL 2,4900012,CDM,981,RC,,,outpatient,,,113.5,73.78,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EMERGENCY DEPT PHYSICIAN LEVEL 3 VISIT,4900013,CDM,981,RC,,,outpatient,,,401.5,260.98,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EMERGENCY DEPT PHYSICIAN LEVEL 4 VISIT,4900014,CDM,981,RC,,,outpatient,,,1291,839.15,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EMERGENCY DEPT PHYSICIAN LEVEL 5 VISIT,4900015,CDM,981,RC,,,outpatient,,,596.5,387.73,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EMER DEPT PHYS CRITICAL CARE 30-74 MINS,4900016,CDM,981,RC,,,outpatient,,,2954,1920.1,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EMER DEPT PHYS CRIT CARE @ ADD'L 30 MINS,4900017,CDM,981,RC,,,outpatient,,,178.5,116.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
ORBITOTOMY WO BONE FLAP W DRAINAGE,4900021,CDM,450,RC,,,outpatient,,,6203,4031.95,,4156.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1736.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1660.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1736.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4528.19,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5582.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1726.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4962.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4652.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1754.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1660.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1736.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5892.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1693.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5272.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3721.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1736.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3721.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1693.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1660.54,5892.85,
VAGINAL DELIVERY ONLY,4900050,CDM,981,RC,,,outpatient,,,4541.5,2951.98,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
NEWBORN ATTENDANCE AT DELIVERY,4900051,CDM,981,RC,,,outpatient,,,258.5,168.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
NEWBORN HISTORY AND EXAMINATION NORMAL,4900052,CDM,981,RC,,,outpatient,,,262.5,170.63,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PHYSICIAN DIRECTION OF EMS,4900054,CDM,981,RC,,,outpatient,,,278.5,181.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SIMP REPAIR (SCALP/NECK/AXIL/TRUNK/EXTRE,4900055,CDM,981,RC,,,outpatient,,,378,245.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SIMPLE REPAIR 2.6cm TO 7.5cm,4900056,CDM,981,RC,,,outpatient,,,875.5,569.08,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SIMPLE REPAIR 7.6cm to 12.5cm,4900057,CDM,981,RC,,,outpatient,,,94.5,61.43,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SIMPLE REPAIR 12.6cm to 20.0cm,4900058,CDM,981,RC,,,outpatient,,,283,183.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INTERVASCULAR CANNULIZATION OR SHUNT REV,4900061,CDM,981,RC,,,outpatient,,,8364,5436.6,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"THROMBOLYSIS,CORONARY;BY IV INFUSION",4900062,CDM,981,RC,,,outpatient,,,532,345.8,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC",4900063,CDM,981,RC,,,outpatient,,,440.6,286.39,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
THORACENTESIS W/INSERTION TUBE,4900066,CDM,981,RC,,,outpatient,,,1091.45,709.44,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CPR INTUBATION,4900067,CDM,981,RC,,,outpatient,,,237,154.05,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"TRACHEOSTOMY, EMERGENCY PROCEDURE",4900068,CDM,981,RC,,,outpatient,,,407.5,264.88,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"INTUBATION, ENDOTRACHEAL, EMERGENCY",4900069,CDM,981,RC,,,outpatient,,,183,118.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
ARTERIAL PUNCTURE,4900071,CDM,981,RC,36600,HCPCS,outpatient,,,65.5,42.58,,,,,,other,Not separately reimbursable for physician setting,16.69,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,21.78,100,,,fee schedule,100% GA Medicaid fee schedule for physician setting,16.69,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,22.65,104,,,fee schedule,104% GA Medicaid fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,16.86,101,,,fee schedule,101% of CMS RBRVS fee schedule for physician setting,21.78,100,,,fee schedule,100% GA Medicaid fee schedule for physician setting,16.69,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,22.22,102,,,fee schedule,102% GA Medicaid fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,16.69,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,22.22,102,,,fee schedule,102% GA Medicaid fee schedule for physician setting,16.69,22.65,
"VENIPUNCTURE,CUTDOWN;UNDER AGE 1 YEAR",4900073,CDM,981,RC,,,outpatient,,,73.5,47.78,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"VENIPUNCTURE,CUTDOWN; AGE 1 OR OVER",4900074,CDM,981,RC,,,outpatient,,,256.18,166.52,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CARDIOVERSION;EXTERNAL,4900075,CDM,981,RC,,,outpatient,,,1247.5,810.88,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
TEMPORARY TRANSCUTANEOUS PACING,4900076,CDM,981,RC,,,outpatient,,,502,326.3,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE SIMPLE,4900078,CDM,981,RC,,,outpatient,,,162.5,105.63,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE COMPLICATED,4900079,CDM,981,RC,,,outpatient,,,222.5,144.63,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE HEMATOMA,4900080,CDM,981,RC,,,outpatient,,,102,66.3,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE PILONIDAL CYSTSIMPL,4900081,CDM,981,RC,,,outpatient,,,426.28,277.08,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE PILONIDAL CYST COMPL,4900082,CDM,981,RC,,,outpatient,,,2265.5,1472.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"AVULSION,NAIL PLATE, PART OR COMP,SIMPLE",4900083,CDM,981,RC,,,outpatient,,,102.5,66.63,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REPAIR NAIL BED,4900084,CDM,981,RC,,,outpatient,,,355.31,230.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EXCISION OF PILONIDAL CYST/SINUS;SIMPLE,4900085,CDM,981,RC,,,outpatient,,,5185,3370.25,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EVACUATION OF SUBINGUAL HEMATOMA,4900086,CDM,981,RC,,,outpatient,,,38,24.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"DEBRIDEMENT;SKIN, & SUBCUTANEOUS TISSUE",4900087,CDM,981,RC,,,outpatient,,,98.5,64.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE BARTHOLIN'S GLAND AB,4900089,CDM,981,RC,,,outpatient,,,371.5,241.48,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
DEBRIDEMENT ECZEMATOUS OR INFECTED SKIN,4900090,CDM,981,RC,,,outpatient,,,75,48.75,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & REMOVAL FOREIGN BODY SUB T SI,4900092,CDM,981,RC,,,outpatient,,,102,66.3,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & REMOVAL FOREIGN BODY COMPLICA,4900093,CDM,981,RC,,,outpatient,,,114,74.1,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REMOVAL FOREIGN BODY,INTRANASAL",4900094,CDM,981,RC,,,outpatient,,,135.5,88.08,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"FOREIGN BODY REMOVAL, EXTERNAL EYE",4900095,CDM,981,RC,,,outpatient,,,98,63.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REMOVAL FOREIGN BODY EXTERNAL AUDITORY,4900096,CDM,981,RC,,,outpatient,,,58.5,38.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"CONTROL NASAL HEMORRHAGE,ANTERIOR,SIMPLE",4900097,CDM,981,RC,,,outpatient,,,72,46.8,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"DRAINAGE EXTERNAL EAR,ABCESS/HEMATOMA;SI",4900098,CDM,981,RC,,,outpatient,,,426.28,277.08,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REMOVAL IMPACTED CERUMEN,4900099,CDM,981,RC,,,outpatient,,,42,27.3,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TREATMENT OF CARPAL SCAPHOID FX,4900100,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX METACARPAL W/O Man @ bone,4900101,CDM,981,RC,,,outpatient,,,338.5,220.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SHOULDER (CLOSED TX) W/MANIP W/O ANESTHE,4900102,CDM,981,RC,,,outpatient,,,356,231.4,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
TREATMENT CLOSED ELBOW DISLOCATION W/O,4900103,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
APPLICATION OF LONG ARM SPLINT SH TO HAN,4900104,CDM,981,RC,,,outpatient,,,53,34.45,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
APPLICATION SHORT ARM SPLINT; STATIC,4900105,CDM,981,RC,,,outpatient,,,208,135.2,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
APPLICATION FINGER SPLINT; STATIC,4900106,CDM,981,RC,,,outpatient,,,51.5,33.48,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
APPLICATION LONG LEG SPLINT THIGH TO ANK,4900107,CDM,981,RC,,,outpatient,,,124,80.6,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
APPLICATION SHORT LEG SPLINT CALF TO FOO,4900108,CDM,981,RC,,,outpatient,,,266.5,173.23,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INITIAL 1ST DEGREE,4900109,CDM,981,RC,,,outpatient,,,102.5,66.63,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
DRSG/DEBRIDE-SMALL,4900110,CDM,981,RC,,,outpatient,,,201,130.65,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
DRSG/DEBRIDE-MEDIUM,4900111,CDM,981,RC,,,outpatient,,,335,217.75,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SIMP REPAIR (FACE/EARS/EYELIDS/NOSE/LIPS,4900112,CDM,981,RC,,,outpatient,,,194.5,126.43,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
2.6 TO 5 CM,4900113,CDM,981,RC,,,outpatient,,,441,286.65,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
5.1 TO 7.5 CM,4900114,CDM,981,RC,,,outpatient,,,201,130.65,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
7.6 TO 12.5 CM,4900115,CDM,981,RC,,,outpatient,,,214,139.1,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LAYER CLOSURE (SCALP/AXILLAE/TRUNK/EXTRM,4900116,CDM,981,RC,,,outpatient,,,746,484.9,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
2.6 TO 7.5,4900117,CDM,981,RC,,,outpatient,,,233,151.45,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
7.6 TO 12.5,4900118,CDM,981,RC,,,outpatient,,,289,187.85,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
12.6 TO 20 CM,4900119,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LAYER CLOSURE (NECK/HAND/FEET),4900120,CDM,981,RC,,,outpatient,,,329,213.85,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
2.6CM TO 7.5CM,4900121,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
7.6CM TO 12.5CM,4900122,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
12.6CM TO 20CM,4900123,CDM,981,RC,,,outpatient,,,1429.61,929.25,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LAYER CLOSURE (FACE/EARS/EYELIDS/NOSE/LI,4900124,CDM,981,RC,,,outpatient,,,746,484.9,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
2.6 TO 5.0 CM,4900125,CDM,981,RC,,,outpatient,,,240,156,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
5.1 TO 7.5 CM,4900126,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
7.5 TO 12.5 CM,4900127,CDM,981,RC,,,outpatient,,,274.5,178.43,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR,COMPLEX,TRUNK 1.1CM TO 2.5CM",4900128,CDM,981,RC,,,outpatient,,,1228.5,798.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR,COMPLEX,TRUNK 2.6CM TO 7.5CM",4900129,CDM,981,RC,,,outpatient,,,1228.5,798.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR,COMPLEX,SCALP/ARMS/&/OR LEGS",4900130,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR,COMPLEX,SCALP/ARMS/&/OR LEGS",4900131,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR,COMPLEX,FOREHEAD/CHEEKS/CHIN/MOUT",4900132,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
2.6 TO 7.5 CM,4900133,CDM,981,RC,,,outpatient,,,1228.5,798.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CENTRAL VENOUS CATH UNDER AGE 5,4900134,CDM,981,RC,,,outpatient,,,2454.5,1595.43,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CENTRAL VENOUS CATH AGE 5 OR OLDER,4900135,CDM,981,RC,,,outpatient,,,1968.6,1279.59,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"GASTROSTOMY TUBE, REPOSITION",4900137,CDM,981,RC,,,outpatient,,,1946.5,1265.23,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"PUNCTURE ASPIRATION ABSCESS,HEMA,CYST",4900138,CDM,981,RC,,,outpatient,,,392,254.8,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR,COMPLEX,EYELIDS,NOSE,EARS,LIPS",4900140,CDM,981,RC,,,outpatient,,,1228.5,798.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
GASTRIC INTUBATION,4900141,CDM,981,RC,,,outpatient,,,114,74.1,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"ARTHROCENTESIS,INTERMEDIATE JOINT",4900142,CDM,981,RC,,,outpatient,,,570.5,370.83,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"INCISION OF THROMBOSED HEMORRHOID,EXTERN",4900143,CDM,981,RC,,,outpatient,,,134,87.1,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
ARTHROCENTESIS; MAJOR JOINT OR BURSA,4900144,CDM,981,RC,,,outpatient,,,57.5,37.38,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"CONTROL NASAL HEMORRHAGE,ANTERIOR,COMPLE",4900145,CDM,981,RC,,,outpatient,,,244,158.6,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX MEACARPOPHALANGEAL DISLOCATION,4900146,CDM,981,RC,,,outpatient,,,634.5,412.43,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX MEACARPOPHALANGEAL DISLOCATION,4900147,CDM,981,RC,,,outpatient,,,966.36,628.13,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"COLPORRHAPHY, SUTURE OF VAGINA (NON-OB)",4900148,CDM,981,RC,,,outpatient,,,4541.5,2951.98,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
VENTILATION ASSIST & MANAGEMENT,4900149,CDM,981,RC,,,outpatient,,,465,302.25,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX METATARSOPHALANGEAL JOINT,4900150,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"CLOSED TX CARPOMETACARPAL DISLOCATION,TH",4900151,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EXCISION BENIGN LESION 1.1 T0 2.0 CM,4900153,CDM,981,RC,,,outpatient,,,160,104,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
7.5 TO 12.5 CM,4900154,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SIMP REPAIR 20.1CM TO 30.0CM,4900159,CDM,981,RC,,,outpatient,,,268.5,174.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
WOUND CLOSURE BY ADHESIVE (DERMABOND),4900168,CDM,981,RC,,,outpatient,,,23.5,15.28,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
DRSG/DEBRIDE-LARGEM,4900169,CDM,981,RC,,,outpatient,,,325.5,211.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REMOVAL EMBEDDED FB EYELID,4900170,CDM,981,RC,,,outpatient,,,453,294.45,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EXCISION EXTERNAL EAR;PARTIAL;SIMPLE,4900171,CDM,981,RC,,,outpatient,,,3502,2276.3,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PERICARDIOCENTESIS; INITIAL,4900172,CDM,981,RC,,,outpatient,,,1287.5,836.88,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
ANOSCOPY; DIAGNOSTIC,4900173,CDM,981,RC,,,outpatient,,,155.5,101.08,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR, PRIMARY, ACHILLES TENDON",4900174,CDM,981,RC,,,outpatient,,,10730.5,6974.83,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
I & D SCROTAL WALL ABSCESS,4900176,CDM,981,RC,,,outpatient,,,2265.5,1472.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"TRACHEOSTOMY, CRICOTHYROID MEMBRANE",4900177,CDM,981,RC,,,outpatient,,,572.5,372.13,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SIMPLE REPAIR OVER 30.0cm,4900178,CDM,981,RC,,,outpatient,,,186.5,121.23,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CHEMICAL CAUTERY TISSUE,4900179,CDM,981,RC,,,outpatient,,,84,54.6,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
FOREIGN BODY REMOVAL EXTERNAL EYE CORNE,4900195,CDM,981,RC,,,outpatient,,,80,52,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REMOVAL FOREIGN BODY, FOOT;COMPLICATED",4900196,CDM,981,RC,,,outpatient,,,1823,1184.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE PERIANAL ABSCESS,4900197,CDM,981,RC,,,outpatient,,,1372,891.8,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
ARTERIAL CATHETERIZATION OR CANNULATION,4900198,CDM,981,RC,,,outpatient,,,124.5,80.93,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"APPLICATION,CAST,ELBOW TO FINGER",4900199,CDM,981,RC,,,outpatient,,,87,56.55,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INJECTION SINGLE OR MULT TRIGGER POINTS,4900200,CDM,981,RC,,,outpatient,,,570.5,370.83,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
STRAPPING; UNNA BOOT,4900201,CDM,981,RC,,,outpatient,,,107.5,69.88,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REMOVAL FOREIGN OBJECT FROM PHARYNX,4900202,CDM,981,RC,,,outpatient,,,256.18,166.52,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"I & D OF EPIDIDYMIS,TESTIS &/OR SCROTAL",4900204,CDM,981,RC,,,outpatient,,,3115.8,2025.27,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX FX PHALANX W/MANIPULATION,4900205,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INSERTION NON-DWELLING BLADDER CATHETER,4900207,CDM,981,RC,,,outpatient,,,33.5,21.78,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INSERTION INDWELLING CATHETER,4900208,CDM,981,RC,,,outpatient,,,56,36.4,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX RADIAL HEAD SUBLUXATION,4900209,CDM,981,RC,,,outpatient,,,97.5,63.38,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX CAPOMETACARPAL DX W/O ANESTHES,4900210,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE UPPER ARM/ELBOW,4900211,CDM,981,RC,,,outpatient,,,4118,2676.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX OF PATELLAR DISLOCATION W/O AN,4900212,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR,COMPLEX,EYELIDS,NOSE,EARS,LIPS",4900213,CDM,981,RC,,,outpatient,,,1228.5,798.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"ARTHROCENTESIS, SMALL JOINT(FING/TOES)",4900214,CDM,981,RC,,,outpatient,,,570.5,370.83,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX INTERPHALANGEAL JOINT DISLOCAT,4900215,CDM,981,RC,,,outpatient,,,197,128.05,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"VENIPUNCTURE, CUTDOWN; < 1 YEAR",4901134,CDM,981,RC,,,outpatient,,,73.5,47.78,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"VENIPUNCTURE, CUTDOWN; > 1 YEAR",4901135,CDM,981,RC,,,outpatient,,,256.18,166.52,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PARING OR CUTTING BENIGN LESION; SINGLE,4911055,CDM,981,RC,,,outpatient,,,224.5,145.93,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
BIOPSY W/SIMPLE CLOSURE; SINGLE LESION,4911100,CDM,981,RC,,,outpatient,,,95,61.75,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EXCISION BENIGN LESION 1.1 TO 2.0cm,4911422,CDM,981,RC,,,outpatient,,,1823,1184.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EXCISION OF NAIL & NAIL MATRIX; PART/COM,4911750,CDM,981,RC,,,outpatient,,,1051,683.15,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REPAIR INTERMEDIATE 20.1CM TO 30.0CM,4912036,CDM,981,RC,,,outpatient,,,1338.5,870.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REPAIR INTERMEDIATE NCK HND FT 12.6cm,4912055,CDM,450,RC,,,outpatient,,,622.5,404.63,,417.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,174.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,166.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,174.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,454.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,560.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,173.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,498,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,466.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,176.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,166.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,174.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,591.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,169.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,529.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,373.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,373.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,166.64,591.38,
"REPAIR,COMPLEX,SCALP/ARMS/&/OR LEGS",4913122,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
COMPLEX REPAIR EA ADD'L 5cm,4913133,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
COMPLEX REPAIR EA ADD'L 5cm,4913153,CDM,981,RC,,,outpatient,,,785.5,510.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SURG PREP RECIP SITE 1ST 100sq cm,4915004,CDM,450,RC,,,outpatient,,,1278.5,831.03,,856.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,357.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,357.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,933.31,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1150.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,355.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1022.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,958.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,361.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,342.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,357.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1214.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,349.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1086.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,767.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,767.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,349.1,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,342.25,1214.58,
SPLIT THICK AUTO GRAFT TRK ARM LEGS,4915100,CDM,981,RC,,,outpatient,,,7055.5,4586.08,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
SPLIT THICK AUTO GRAFT TRK ARM LEGS,4915101,CDM,981,RC,,,outpatient,,,7055.5,4586.08,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"MASTOTOMY W/EXPLORATION ABSCESS,DEEP",4919020,CDM,981,RC,,,outpatient,,,267,173.55,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION AND DRAINAGE SOFT TISS SUBFASC,4920005,CDM,981,RC,,,outpatient,,,467,303.55,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EXPLORATION PENETRATING WOUND EXTREMITY,4920103,CDM,981,RC,,,outpatient,,,2265.5,1472.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INJECTION SINGLE TENDON SHEATH LIG APON,4920550,CDM,981,RC,,,outpatient,,,570.5,370.83,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REPLANTATION DIGIT EXCL THUMB,4920822,CDM,450,RC,,,outpatient,,,6956.5,4521.73,,4660.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1947.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1862.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1947.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5078.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6260.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1936.75,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5565.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5217.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1967.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1862.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1947.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6608.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1899.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5913.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4173.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1947.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4173.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1899.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1862.26,6608.68,
EXCISION TUMOR SOFT TSS FACE/SCALP SQ 2+,4921011,CDM,981,RC,,,outpatient,,,1823,1184.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX NASAL BONE FX W/O STABILIZATIO,4921315,CDM,981,RC,,,outpatient,,,5047,3280.55,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX CLAVICULAR FX W/O MANIPULATION,4923500,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX ACROMIOCLAVICULAR DISLOCATION,4923545,CDM,981,RC,,,outpatient,,,378,245.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX PROXIMAL HUMERAL W/MAN W/W/O T,4923605,CDM,981,RC,,,outpatient,,,2608.5,1695.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX ULNAR FX PROXIMAL W/O MANIP,4924670,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"ARTHROTOMY, WRIST JOINT W/EXPLORATION",4925101,CDM,981,RC,,,outpatient,,,7200.5,4680.33,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX ULNAR SHAFT FX W/O MANIPULATIO,4925530,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX DISTAL RADIAL FX,4925600,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX DISTAL RADIAL FX W/MANIPULATIO,4925605,CDM,981,RC,,,outpatient,,,1245.5,809.58,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
DRAINAGE FINGER ABSCESS; SIMPLE,4926010,CDM,981,RC,,,outpatient,,,235.2,152.88,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
DRAINAGE OF FINGER ABSCESS; COMPLICATED,4926011,CDM,981,RC,,,outpatient,,,283,183.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR, EXT TENDON, FINGER",4926418,CDM,981,RC,,,outpatient,,,3701,2405.65,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX METACARPAL TX W/MANIPULATION,4926605,CDM,981,RC,,,outpatient,,,338.5,220.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX PHALANGEAL SHAFT FX W/MANI,4926725,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX INTERPHALANGEAL JOINT W ANEST,4926775,CDM,981,RC,,,outpatient,,,690,448.5,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"CLOSED TX FEMORAL FX, DISTAL END, NECK",4927230,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"I & D DEEP ABCESS, BURSA, THIGH OR KNEE",4927301,CDM,981,RC,,,outpatient,,,4118,2676.7,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX DISTAL FIB FX W/O MANIPULATION,4927786,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX FX DISTAL TIBIA W/O MANIPULAT,4927825,CDM,981,RC,,,outpatient,,,2608.5,1695.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"EXCISION, INTERDIGITAL NEUROMA",4928080,CDM,981,RC,,,outpatient,,,4945,3214.25,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REMOVAL FB FOOT SUBCUTANEOUS,4928190,CDM,981,RC,,,outpatient,,,1823,1184.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX INTERPHALANGEAL JOINT DISLOC,4928660,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CLOSED TX INTERPHALANGEAL JOINT DISLOC,4928665,CDM,981,RC,,,outpatient,,,418.5,272.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
APPLICATION CAST FIGURE OF EIGHT,4929049,CDM,981,RC,,,outpatient,,,314.5,204.43,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
APPLICATION CAST HAND & LOWER FOREARM,4929085,CDM,981,RC,,,outpatient,,,296,192.4,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
APPLICATION SHORT ARM SPLINT; DYNAMIC,4929126,CDM,981,RC,,,outpatient,,,262,170.3,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
APPLICATION FINGER SPLINT; DYNAMIC,4929131,CDM,981,RC,,,outpatient,,,51.5,33.48,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
STRAPPING; SHOULDER,4929240,CDM,981,RC,29240,HCPCS,outpatient,,,169.5,110.18,,,,,,other,Not separately reimbursable for physician setting,20.45,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,49.84,100,,,fee schedule,100% GA Medicaid fee schedule for physician setting,20.45,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,51.83,104,,,fee schedule,104% GA Medicaid fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,20.65,101,,,fee schedule,101% of CMS RBRVS fee schedule for physician setting,49.84,100,,,fee schedule,100% GA Medicaid fee schedule for physician setting,20.45,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,50.84,102,,,fee schedule,102% GA Medicaid fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,20.45,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,50.84,102,,,fee schedule,102% GA Medicaid fee schedule for physician setting,20.45,51.83,
STRAPPING; HAND OR FINGER,4929280,CDM,981,RC,29280,HCPCS,outpatient,,,169.5,110.18,,,,,,other,Not separately reimbursable for physician setting,22.26,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,38.21,100,,,fee schedule,100% GA Medicaid fee schedule for physician setting,22.26,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,39.74,104,,,fee schedule,104% GA Medicaid fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,22.48,101,,,fee schedule,101% of CMS RBRVS fee schedule for physician setting,38.21,100,,,fee schedule,100% GA Medicaid fee schedule for physician setting,22.26,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,38.97,102,,,fee schedule,102% GA Medicaid fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,22.26,100,,,fee schedule,100% of CMS RBRVS fee schedule for physician setting,,,,,other,Not separately reimbursable for physician setting,38.97,102,,,fee schedule,102% GA Medicaid fee schedule for physician setting,22.26,39.74,
APPLICATION SHORT LEG CAST,4929405,CDM,981,RC,,,outpatient,,,114,74.1,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
STRAPPING; ANKLE AND/OR FOOT,4929540,CDM,981,RC,,,outpatient,,,99.05,64.38,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
UNLISTED CASTING OR STRAPPING PROCEDURE,4929799,CDM,981,RC,,,outpatient,,,296,192.4,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"CONTROL NASAL HEMORRHAGE, POSTERIOR",4930905,CDM,981,RC,,,outpatient,,,153.5,99.78,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
TRACH TUBE CHANGE,4931502,CDM,981,RC,,,outpatient,,,165,107.25,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
LARYNGOSCOPY INDIRECT DIAGNOSITC,4931525,CDM,981,RC,,,outpatient,,,4292,2789.8,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
THORACOSTOMY (CHEST TUBE),4932020,CDM,981,RC,,,outpatient,,,229.5,149.18,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REPAIR BLOOD VESSEL DIRECT HAND FINGER,4935207,CDM,981,RC,,,outpatient,,,7368.5,4789.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"REPAIR BLOOD VESSEL, LOWER EXTREMITY",4935226,CDM,981,RC,,,outpatient,,,1823,1184.95,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
PLACEMENT OF NEEDLE INTRAOSSEOUS INFUSIO,4936680,CDM,981,RC,,,outpatient,,,384,249.6,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
THROMBOLYSIS CEREBRAL BY IV INFUSION,4937195,CDM,981,RC,,,outpatient,,,130,84.5,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"TRANSCATHETER THERAPY, INFUSION THROMBOL",4937201,CDM,981,RC,,,outpatient,,,3220.24,2093.16,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
NEUROMUSCULAR REEDUCATION @ 15 MINS,4940007,CDM,440,RC,,,outpatient,,,140.5,91.33,,94.14,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,37.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,126.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,39.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,112.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,105.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,39.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,37.61,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,38.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,119.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,84.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,84.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,37.61,133.48,
"REPAIR LAC 2.5cm OR LESS, MOUTH",4941250,CDM,981,RC,,,outpatient,,,244,158.6,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
DRAINAGE ABSCESS CYST HEMATOMA DENTOALV,4941800,CDM,981,RC,,,outpatient,,,182.5,118.63,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE SUBMUCOSAL ACESS,4945005,CDM,981,RC,,,outpatient,,,720.93,468.6,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE SUPRALEVATOR PELVI,4945020,CDM,981,RC,,,outpatient,,,4433,2881.45,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
I & D PERIRECTAL ABCESS,4946040,CDM,981,RC,,,outpatient,,,400,260,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"INJECTION SCLEROSING SOLUT, HEMMORRHOID",4946500,CDM,981,RC,,,outpatient,,,1372,891.8,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
ABDOMINAL PARACENTESIS DX/THER W/O IMAGI,4949082,CDM,981,RC,,,outpatient,,,371.4,241.41,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"SUTURE, SEC, ABD WALL FOR EVIS/DEHIS",4949900,CDM,981,RC,,,outpatient,,,1546.5,1005.23,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"BLADDER IRRIGATION;SIMPLE,LAVAGE &or INS",4951700,CDM,981,RC,,,outpatient,,,477.5,310.38,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"INSERT INDWELL CATH, COMPLICATED",4951703,CDM,981,RC,,,outpatient,,,256.5,166.73,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"SLITTING PERPUCE,DOR OR LAT; EXC NB",4954001,CDM,981,RC,,,outpatient,,,4807.5,3124.88,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
INCISION & DRAINAGE VULVA/PERINAL ABS,4956405,CDM,981,RC,,,outpatient,,,146,94.9,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
MARSUPIALIZATION BARTHOLIN'S GLAND CYST,4956440,CDM,981,RC,,,outpatient,,,4541.5,2951.98,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
EPISIOTOMY OR VAG REPAIR NOT ATTENDING,4959300,CDM,981,RC,,,outpatient,,,4541.5,2951.98,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
VAGINAL DELIVERY ONLY AFTER PREV C SECTI,4959612,CDM,981,RC,,,outpatient,,,4314,2804.1,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
CERVICAL PUNCTURE W MED INJECTION,4961055,CDM,981,RC,,,outpatient,,,2098.5,1364.03,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"INJECTION SINGLE LUMBAR,SACRAL",4962311,CDM,981,RC,,,outpatient,,,1766,1147.9,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
NERVE BLOCK PERIPHERAL NERVE,4964450,CDM,981,RC,,,outpatient,,,1658.02,1077.71,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"DRAINAGE OF ABSCESS, EYELID",4967700,CDM,981,RC,,,outpatient,,,723.5,470.28,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
REPAIR-SIMPLE 12.6CM TO 20.0CM,4980060,CDM,981,RC,,,outpatient,,,268.5,174.53,,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,,,other,Not separately reimbursable for physician setting,,,
"ARTHROSCOPY,KNEE,SURGICAL,REMOVAL FB",9000289,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
HYLAN G-F 20 INJECTION,9007320,CDM,360,RC,,,outpatient,,,467.5,303.88,,313.23,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,130.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,341.28,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,420.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,130.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,374,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,350.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,132.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,125.15,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,444.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,127.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,397.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,280.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,280.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.65,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,125.15,444.13,
FINE NEEDLE ASPIRATN; W/O IMAG GUID,9010021,CDM,360,RC,,,outpatient,,,368,239.2,,246.56,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.64,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,331.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,102.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,294.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,276,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,104.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,98.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,349.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,100.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,312.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,220.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,220.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,98.51,349.6,
FINE NEEDLE ASPIRATN; W/ IMAG GUID,9010022,CDM,360,RC,,,outpatient,,,1079.5,701.68,,723.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,288.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,788.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,971.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,300.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,863.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,809.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,305.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,288.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1025.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,294.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,917.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,647.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,647.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,288.98,1025.53,
INCISION & DRAINAGE SIMPLE OR SINGLE,9010060,CDM,360,RC,,,outpatient,,,162.5,105.63,,108.88,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,45.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,43.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,45.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.63,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,146.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,45.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,130,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,121.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,45.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,43.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,45.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,154.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,44.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,138.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,97.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,43.5,154.38,
INCISION & DRAINAGE COMPLICATED MULT,9010061,CDM,360,RC,,,outpatient,,,222.5,144.63,,149.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,162.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,200.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,61.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,178,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,166.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,62.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,59.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,211.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,60.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,189.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,133.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,59.56,211.38,
INCISION & REMOVAL FB SUBCU TISSUE SIMP,9010120,CDM,360,RC,,,outpatient,,,102,66.3,,68.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,91.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,81.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.31,96.9,
INCISION & REMOVAL FOREIGN BODY COMPLICA,9010121,CDM,360,RC,,,outpatient,,,114,74.1,,76.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,83.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,102.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,31.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,91.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,85.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,32.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,30.52,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,96.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,68.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,30.52,108.3,
"PUNCTURE ASPIRATION OF ABSCESS,HEMATOMA",9010160,CDM,360,RC,,,outpatient,,,392,254.8,,262.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,352.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,109.14,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,313.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,294,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,110.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,104.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,372.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,107.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,333.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,235.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,235.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.94,372.4,
INCISION AND DRAINAGE COMPLEX POSTOP WOU,9010180,CDM,360,RC,,,outpatient,,,240,156,,160.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,175.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,216,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,66.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,192,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,180,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,67.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,64.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,228,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,65.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,204,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.25,228,
DEBRIDEMENT ECZEMATOUS SKIN 10%,9011000,CDM,360,RC,,,outpatient,,,75,48.75,,50.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,60,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,56.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.08,71.25,
DEBRIDEMENT SKIN EXT GENITALIA  (IP ONLY,9011004,CDM,360,RC,,,outpatient,,,1739.5,1130.68,,1165.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,487.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,465.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,487.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1269.84,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1565.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,484.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1391.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1304.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,491.93,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,465.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,487.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1652.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,474.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1478.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1043.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,487.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1043.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,474.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,465.66,1652.53,
DEBRIDEMENT/REMOVAL FM W/OPEN FX,9011010,CDM,360,RC,,,outpatient,,,561,364.65,,375.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,157.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,150.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,157.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,409.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,504.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,156.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,448.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,420.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,158.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,150.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,157.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,532.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,153.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,476.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,336.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,336.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,153.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,150.18,532.95,
DEBRIDEMENT; SKIN & SUBCU TISSUE,9011042,CDM,360,RC,,,outpatient,,,98.5,64.03,,66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,26.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,88.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,27.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,78.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,73.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,27.86,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,26.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,26.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,83.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,59.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,59.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,26.37,93.58,
DEBRIDEMENT; SKIN & SUBCU TISSUE,9011043,CDM,360,RC,,,outpatient,,,367,238.55,,245.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,102.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,102.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,267.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,330.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,102.18,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,293.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,275.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,103.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,98.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,102.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,348.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,100.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,311.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,220.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,220.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,98.25,348.65,
DEBRIDEMENT SKIN SUBCUT TISS MUSCL BONE,9011044,CDM,360,RC,,,outpatient,,,75,48.75,,50.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,60,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,56.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.08,71.25,
DEBRIDEMENT; SKIN & SUBCU TISSUE @ ADD'L,9011045,CDM,360,RC,,,outpatient,,,1789.5,1163.18,,1198.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,501.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,479.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,501.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1306.34,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1610.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,498.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1431.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1342.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,506.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,479.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,501.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1700.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,488.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1521.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1073.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,501.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1073.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,488.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,479.05,1700.03,
BIOPSY SKIN/SUBCU/MUC MEMB;SINGLE LESION,9011100,CDM,360,RC,,,outpatient,,,95,61.75,,63.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,71.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.43,90.25,
BIOPSY SKIN SUBCU/MUC MEM/@ ADD;L LESION,9011101,CDM,360,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
REMOVAL SKIN TAGS/MULTIPLE TAGS,9011200,CDM,360,RC,,,outpatient,,,75,48.75,,50.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,67.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,20.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,60,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,56.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,21.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,20.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,20.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,63.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.48,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,20.08,71.25,
REMOVAL SKIN TAGS/MULTi TAGS @ addl 10,9011201,CDM,360,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
SHAVING EPI/DERMAL LESION SINGLE 05cm <,9011300,CDM,360,RC,,,outpatient,,,479.5,311.68,,321.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,134.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,134.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,350.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,431.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,133.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,383.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,359.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,135.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,128.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,134.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,455.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,130.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,407.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,287.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,134.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,287.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,128.36,455.53,
"SHAVING SKIN LES, SINGLE, 0.6-1.0cm",9011301,CDM,360,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
SHAVING OF EPIDERMAL/DERM LESION 1.1-2.0,9011302,CDM,360,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
"SHAVING SKIN LESION,SINGE, >2.0CM",9011303,CDM,360,RC,,,outpatient,,,335,217.75,,224.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,244.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,301.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,93.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,268,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,251.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,318.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,284.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.68,318.25,
SHAVING EPI/DERMAL SGLE LESION 0.6 T0 1.,9011306,CDM,360,RC,,,outpatient,,,479.5,311.68,,321.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,134.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,134.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,350.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,431.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,133.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,383.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,359.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,135.6,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,128.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,134.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,455.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,130.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,407.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,287.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,134.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,287.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,128.36,455.53,
"EXCISION, BENIGN LESION 0.5CM OR LESS",9011400,CDM,360,RC,,,outpatient,,,102,66.3,,68.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,91.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.4,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,81.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.86,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.31,96.9,
"EXCISION, BENIGN LESION, 0.6CM TO 1.0CM",9011401,CDM,360,RC,,,outpatient,,,121,78.65,,81.07,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,33.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,32.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,108.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,33.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,96.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,90.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,34.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,32.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,33.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,114.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,33.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,32.39,114.95,
"EXCISION, BENIGN LESION, 1.1CM TO 2.0CM",9011402,CDM,360,RC,,,outpatient,,,160,104,,107.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,44.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,42.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,116.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,144,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,44.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,128,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,120,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,45.25,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,42.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,44.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,43.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,136,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,42.83,152,
EXCISION BENIGN LESION 2.1cm TO 3.0cm,9011403,CDM,360,RC,,,outpatient,,,180,117,,120.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,162,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,144,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,135,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,50.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,171,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,153,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.19,171,
"EXCISION,BENIGN LESION, 3.1CM TO 4.0CM",9011404,CDM,360,RC,,,outpatient,,,235,152.75,,157.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,65.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,171.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,211.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,65.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,188,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,176.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,66.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,62.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,223.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,199.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,141,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.91,223.25,
"EXCISION, BENIGN LESION, OVER 4.0CM",9011406,CDM,360,RC,,,outpatient,,,1265,822.25,,847.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,354.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,338.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,354.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,923.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1138.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,352.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1012,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,948.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,357.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,338.64,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,354.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1201.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,345.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1075.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,759,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,354.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,759,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345.41,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,338.64,1201.75,
EXCISION BENIGN LESION 0.5CM OR LESS,9011420,CDM,360,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
EXCISION BENIGN LESION 0.6 TO 1.0 CM,9011421,CDM,360,RC,,,outpatient,,,168.5,109.53,,112.9,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,45.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,123.01,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,151.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,46.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,134.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,126.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,47.65,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,45.11,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,46.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,143.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,101.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.01,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,45.11,160.08,
"EXCISION, BENIGN LESION, DIAM 1.1 TO 2.O",9011422,CDM,360,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
EXCISION BENIGN LESION 2.1 TO 3.0cm,9011423,CDM,360,RC,,,outpatient,,,227,147.55,,152.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,63.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,165.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,204.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,63.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,181.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,170.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,64.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,63.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,215.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,192.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,136.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,136.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.77,215.65,
EXCISION BENIGN LESION 3.1 TO 4,9011424,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
EXCISION BENIGN LESION OVER 4.0CM,9011426,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
"EXCISION, BENIGN LESION, DIAM 0.50 OR LE",9011440,CDM,360,RC,,,outpatient,,,1051,683.15,,704.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,767.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,945.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,292.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,840.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,788.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,297.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,998.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,893.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,281.35,998.45,
EXCISION BENIGN LESION; 0.6CM TO 1.0CM,9011441,CDM,360,RC,,,outpatient,,,180,117,,120.6,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,48.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,131.4,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,162,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,50.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,144,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,135,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,50.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,48.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,171,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,49.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,153,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.19,171,
EXCISION BENIGN LESION; 1.1CM TO 2.0CM,9011442,CDM,360,RC,,,outpatient,,,197,128.05,,131.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,55.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,143.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,177.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,157.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,147.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,55.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,187.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,167.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.74,187.15,
"EXCISION, BENIGN LESION, DIAM 2.1 TO 3.0",9011443,CDM,360,RC,,,outpatient,,,281,182.65,,188.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,78.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,205.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,252.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,224.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,210.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,79.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,78.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,266.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,76.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,238.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,168.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,168.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.72,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.22,266.95,
"EXCISION, BENIGN LESION, DIAM 3.1 - 4.0",9011444,CDM,360,RC,,,outpatient,,,1093.8,710.97,,732.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,306.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,292.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,306.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,798.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,984.42,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,304.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,875.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,820.35,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,309.33,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,292.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,306.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1039.11,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,298.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,929.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,656.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,656.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,298.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,292.81,1039.11,
"EXCISION, BENIGN LESION, DIAM OVER 4.0cm",9011446,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
EXCISION HIDRADENITIS AXILLARY,9011450,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
EXCISION FOR HIDRADENITITS,9011451,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
"EXCISION, MAL LESION; 0.6cm TO 1.0cm",9011601,CDM,360,RC,,,outpatient,,,1051,683.15,,704.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,767.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,945.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,292.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,840.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,788.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,297.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,998.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,893.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,281.35,998.45,
"EXCISION, MALIGNANT LESION, 1.1 TO 2.0CM",9011602,CDM,360,RC,,,outpatient,,,264.5,171.93,,177.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,70.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,193.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,238.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,73.64,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,211.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,198.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,74.8,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,70.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,72.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,224.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,158.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,158.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,70.81,251.28,
EXCISION MALIGN LESION 2.1 TO 3CM,9011603,CDM,360,RC,,,outpatient,,,273.5,177.78,,183.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,76.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,73.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,76.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,246.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,76.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,218.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,205.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,77.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,73.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,76.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,259.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,74.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,232.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,164.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,164.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.68,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,73.22,259.83,
EXCISION MAL LESION 3.1cm-4.0cm,9011604,CDM,360,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
EXCISION MAL LESION OVER 4.0CM,9011606,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
EXCISION MALIGN LESION 0.5CM <,9011620,CDM,360,RC,,,outpatient,,,2941,1911.65,,1970.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,823.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,787.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,823.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2146.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2646.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,818.8,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2352.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2205.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,831.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,787.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,823.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2793.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,803.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2499.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1764.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,823.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,803.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,787.31,2793.95,
EXCISION MALIGN LESION 1.1 TO 2.0CM,9011622,CDM,360,RC,,,outpatient,,,309.5,201.18,,207.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,86.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,82.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,86.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,225.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,278.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,86.16,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,247.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,232.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,87.53,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,82.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,86.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,294.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,84.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,263.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,185.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,185.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,82.85,294.03,
EX MAL SCLP NK FT HND GNTL 2.1 3.0 CM,9011623,CDM,360,RC,,,outpatient,,,456,296.4,,305.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,127.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,122.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,127.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,332.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,410.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,126.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,364.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,342,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,128.96,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,122.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,127.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,433.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,124.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,387.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,273.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,273.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.51,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,122.07,433.2,
EX MAL SCLP NK FT HND GNTL 3.1 4.0 CM,9011624,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
EXCISION MALIG LESION OVER 4.0cm,9011626,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
EXCIS MALIGN LESION f/e/e/n/l/m 0.5cm/<,9011640,CDM,360,RC,,,outpatient,,,1051,683.15,,704.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,767.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,945.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,292.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,840.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,788.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,297.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,998.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,893.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,281.35,998.45,
EXCISION MALIG LES F/E/E/B/L/M 0.6-1.0cm,9011641,CDM,360,RC,,,outpatient,,,321.5,208.98,,215.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,90.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,90.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,289.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,89.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,257.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,241.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,90.92,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,86.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,90.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,87.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,273.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,192.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,192.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.07,305.43,
EX MAL SCLP NK FT HND GNTL FCE 1.1 2.0CM,9011642,CDM,360,RC,,,outpatient,,,390,253.5,,261.3,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,284.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,351,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,108.58,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,312,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,292.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,110.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,104.4,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,370.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,106.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,331.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,234,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.4,370.5,
EXCISION MALIGNANT LESION 2.1 to 3.0cm,9011643,CDM,360,RC,,,outpatient,,,381.5,247.98,,255.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,106.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,106.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,278.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,343.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,106.22,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,305.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,286.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,107.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,102.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,106.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,362.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,104.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,324.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,228.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,228.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102.13,362.43,
"EXCISION, MALIGNANT LESION 3.1cm to 4.0",9011644,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
EXCISION MALIG LESION OVER 4.0cm,9011646,CDM,360,RC,,,outpatient,,,3111,2022.15,,2084.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,871.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,832.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,871.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2271.03,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2799.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,866.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2488.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2333.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,879.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,832.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,871.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2955.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,849.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2644.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1866.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,871.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1866.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,849.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,832.81,2955.45,
DEBRIDEMENT NAIL(S); 6 OR MORE,9011721,CDM,360,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
"AVULSION OF NAIL PLATE, SIMPLE; SINGLE",9011730,CDM,360,RC,,,outpatient,,,102.5,66.63,,68.68,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,27.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,74.83,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,92.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,28.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,82,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,76.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,28.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,27.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,97.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,27.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,87.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,61.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,61.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.99,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,27.44,97.38,
"AVULSION OF NAIL PLATE, @ ADD'L PLATE",9011732,CDM,360,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
EXCISION OF NAIL & MATRIX; PART OR COMPL,9011750,CDM,360,RC,,,outpatient,,,1051,683.15,,704.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,767.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,945.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,292.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,840.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,788.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,297.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,998.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,893.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,281.35,998.45,
"EXCISION NAIL & NAIL MATRIX, PART/COMP",9011752,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
BIOPSY NAIL UNIT,9011755,CDM,360,RC,,,outpatient,,,1051,683.15,,704.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,767.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,945.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,292.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,840.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,788.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,297.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,998.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,893.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,281.35,998.45,
REPAIR NAIL BED,9011760,CDM,360,RC,,,outpatient,,,355.31,230.95,,238.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,99.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,95.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,99.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,259.38,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,319.78,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,98.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,284.25,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,266.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,100.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,95.12,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,99.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,337.54,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,97.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,302.01,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,213.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.02,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,95.12,337.54,
EXCISION PILONIDAL CYST/SINUS; SIMPLE,9011770,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
EXCISION PILONIDAL CYST/SINUS; EXTENSIVE,9011771,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
EXCISION PILONIDAL CYST; COMPLICATED,9011772,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
INJECTION INTRALESIONAL UP TO 7 LESIONS,9011900,CDM,360,RC,,,outpatient,,,56.5,36.73,,37.86,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.25,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,50.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,15.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,45.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,42.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,15.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.13,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.68,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.03,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,33.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.43,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.13,53.68,
SIMPLE REPAIR SUPERFICIAL WOUND;2.5CM <,9012001,CDM,360,RC,,,outpatient,,,378,245.7,,253.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,101.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,275.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,340.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,105.24,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,302.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,283.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,106.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,101.19,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,359.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,103.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,321.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,226.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,226.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,101.19,359.1,
SIMPLE REPAIR 2.5CM OR LESS,9012011,CDM,360,RC,,,outpatient,,,194.5,126.43,,130.32,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,54.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,52.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.99,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,175.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,54.15,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,155.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,145.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,52.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,54.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,184.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,53.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,165.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,116.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.46,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,116.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,52.07,184.78,
SIMPLE REPAIR 2.6cm TO 5.0cm,9012013,CDM,360,RC,,,outpatient,,,441,286.65,,295.47,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,123.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,118.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,321.93,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,396.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,122.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,352.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,330.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,124.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,118.06,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,123.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,418.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,120.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,374.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,264.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,264.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.42,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,118.06,418.95,
LAYER CLOSURE 2.5CM OR LESS,9012031,CDM,360,RC,,,outpatient,,,746,484.9,,499.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,544.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,671.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,207.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,596.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,559.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,210.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,199.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,708.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,203.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,634.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,447.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,447.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,203.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,199.7,708.7,
LAYER CLOSURE 2.6CM TO 7.5CM,9012032,CDM,360,RC,,,outpatient,,,233,151.45,,156.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,65.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,170.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,209.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,64.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,186.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,174.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,65.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,62.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,221.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,63.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,198.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,139.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,139.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.37,221.35,
LAYER CLOSURE 7.6 TO 12.5 CM,9012034,CDM,360,RC,,,outpatient,,,289,187.85,,193.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,80.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,77.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,260.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,80.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,231.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,216.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,81.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,77.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,80.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,274.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,78.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,245.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,173.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,173.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,77.37,274.55,
LAYER CLOSURE 12.6 TO 20.0,9012035,CDM,360,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
LAYER CLOSURE 2.5CM OR LESS,9012041,CDM,360,RC,,,outpatient,,,329,213.85,,220.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,92.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,88.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,240.17,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,296.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,91.59,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,263.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,246.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,93.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,88.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,92.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,312.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,89.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,279.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,197.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.12,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,197.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,88.07,312.55,
LAYER CLOSURE 2.6 TO 7.5CM,9012042,CDM,360,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
LAYER CLOSURE 7.6CM TO 12.5CM,9012044,CDM,360,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
LAYER CLOSURE 2.5CM OR LESS,9012051,CDM,360,RC,,,outpatient,,,746,484.9,,499.82,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,199.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,544.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,671.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,207.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,596.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,559.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,210.97,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,199.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,708.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,203.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,634.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,447.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.88,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,447.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,203.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,199.7,708.7,
LAYER CLOSURE 2.5cm 50 5.0cm,9012052,CDM,360,RC,,,outpatient,,,240,156,,160.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,64.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,175.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,216,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,66.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,192,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,180,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,67.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,64.25,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,228,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,65.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,204,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,64.25,228,
LAYER CLOSURE 5.1 - 7.5CM,9012053,CDM,360,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
"COMPLEX REPAIR, TRUNK, 2.6cm TO 7.5cm",9013101,CDM,360,RC,,,outpatient,,,1228.5,798.53,,823.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,896.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1105.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,342.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,982.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,921.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,347.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1167.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1044.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,328.87,1167.08,
"COMPLEX REPAIR, TRUNK, EA ADD'L 5cm OR L",9013102,CDM,360,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
"REPAIR, COMPLEX, 2.6CM TOP 7.5CM",9013121,CDM,360,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
"REPAIR, COMPLEX, @ ADD'L 5CM",9013122,CDM,360,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
"REPAIR, COMPLEX; 2.6cm TO 7.5cm",9013132,CDM,360,RC,,,outpatient,,,1228.5,798.53,,823.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,896.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1105.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,342.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,982.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,921.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,347.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,328.87,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1167.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1044.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,343.98,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,737.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,335.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,328.87,1167.08,
"REPAIR, COMPLEX; @ ADD'L 5cm OR LESS",9013133,CDM,360,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
"FULL THICKNESS GRAFT,FREE,INC CLOS DONOR",9015240,CDM,360,RC,,,outpatient,,,3470.5,2255.83,,2325.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,971.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,929.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,971.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2533.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3123.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,966.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2776.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2602.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,981.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,929.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,971.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3296.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,947.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2949.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2082.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,971.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2082.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,947.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,929.05,3296.98,
FULL GRFT FC HND FT GNTL AXL EA AD 20 CM,9015241,CDM,360,RC,,,outpatient,,,785.5,510.58,,526.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,706.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.69,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,667.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,219.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.49,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.28,746.23,
REMOVAL OF SUTURES UNDER ANESTHESIA,9015851,CDM,360,RC,,,outpatient,,,655,425.75,,438.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,183.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,175.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,183.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,478.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,589.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,182.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,524,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,491.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,185.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,175.34,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,183.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,622.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,178.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,556.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,393,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,393,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,178.85,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,175.34,622.25,
"DESTRUCTION BENIGN LESION, FIRST LESION",9017000,CDM,360,RC,,,outpatient,,,95,61.75,,63.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,69.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,85.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,26.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,76,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,71.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,26.87,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,25.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,90.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,80.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,25.43,90.25,
"DESTRUCTION BENIGN LESION, 2ND THRU 14",9017003,CDM,360,RC,,,outpatient,,,22.5,14.63,,15.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,16.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,20.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,6.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,18,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6.36,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,6.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,21.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,19.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,13.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6.02,21.38,
DESTRUCTION OF FLAT WARTS UP TO 14 LESIO,9017110,CDM,360,RC,,,outpatient,,,224.5,145.93,,150.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,163.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,202.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,62.5,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,179.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,168.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,63.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,60.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,213.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,190.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,134.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,60.1,213.28,
MASTOTOMY W/EXPLOR/DRAIN ABSCESS; DEEP,9019020,CDM,360,RC,,,outpatient,,,267,173.55,,178.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,74.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,71.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,194.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,240.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,74.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,213.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,200.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,75.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,71.48,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,74.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,253.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,72.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,226.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,160.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,160.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,71.48,253.65,
"BIOPSY BREAST; PERCUTANEOUS, NEEDLE CORE",9019100,CDM,360,RC,,,outpatient,,,1079.5,701.68,,723.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,288.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,788.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,971.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,300.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,863.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,809.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,305.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,288.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1025.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,294.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,917.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,647.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,647.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,288.98,1025.53,
"BIOPSY BREAST; OPEN, INCISIONAL",9019101,CDM,360,RC,,,outpatient,,,467,303.55,,312.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,130.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,125.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,340.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,420.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,130.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,373.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,350.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,132.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,125.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,130.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,443.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,127.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,396.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,280.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,280.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,125.02,443.65,
"EXCISION OF CYST,FIBROADENOMA OR BENIGN",9019120,CDM,360,RC,,,outpatient,,,5814,3779.1,,3895.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1627.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1556.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1627.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4244.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5232.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1618.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4651.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4360.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1644.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1556.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1627.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5523.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1587.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4941.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3488.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3488.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1587.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1556.41,5523.3,
EXCISION OF BREAST LESION; SINGLE LESION,9019125,CDM,360,RC,,,outpatient,,,500,325,,335,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,140,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,133.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,365,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,450,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,139.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,400,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,375,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,141.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,133.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,140,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,475,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,136.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,425,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,133.85,475,
PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZ,9019290,CDM,360,RC,,,outpatient,,,322,209.3,,215.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,90.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,86.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,90.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,235.06,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,289.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,89.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,257.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,241.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,91.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,86.2,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,90.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,87.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,273.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,193.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,193.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,86.2,305.9,
MASTECTOMY PARTIAL,9019301,CDM,360,RC,,,outpatient,,,5814,3779.1,,3895.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1627.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1556.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1627.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4244.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5232.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1618.67,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4651.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4360.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1644.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1556.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1627.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5523.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1587.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4941.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3488.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.92,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3488.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1587.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1556.41,5523.3,
MASTECTOMY SUBCUTANEOUS,9019304,CDM,360,RC,,,outpatient,,,7675.5,4989.08,,5142.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2149.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2054.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2149.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5603.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6907.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2136.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6140.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5756.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2170.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2054.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2149.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7291.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2095.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6524.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4605.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2149.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4605.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2095.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2054.73,7291.73,
"MASTECTOMY, MODIFIED RADICAL",9019307,CDM,360,RC,,,outpatient,,,10101.5,6565.98,,6768.01,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2828.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2704.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2828.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7374.1,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9091.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2812.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8081.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7576.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2856.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2704.17,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2828.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9596.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2758.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8586.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6060.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2828.42,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6060.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2758.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2704.17,9596.43,
"BIOPSY, MUSCLE, SUPERFICIAL",9020200,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
BIOPSY MUSCLE DEEP,9020205,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
REMOVAL FB MUSCLE/TENDON SHEATH; SIMPLE,9020520,CDM,360,RC,,,outpatient,,,1051,683.15,,704.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,767.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,945.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,292.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,840.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,788.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,297.22,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,281.35,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,998.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,893.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,630.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.98,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,281.35,998.45,
REMOVAL FB MUSCLE/TENDON SHEATH; COMPLIC,9020525,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
"ARTHROCENTESIS,SMALL JOINT",9020600,CDM,360,RC,,,outpatient,,,570.5,370.83,,382.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,513.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,158.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,456.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,427.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,161.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,541.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,484.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,152.72,541.98,
"ARTHROCENTESIS, INTERMEDIATE JOINT",9020605,CDM,360,RC,,,outpatient,,,570.5,370.83,,382.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,513.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,158.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,456.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,427.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,161.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,541.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,484.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,152.72,541.98,
"ARTHROCENTESIS, MAJOR JOINT",9020610,CDM,360,RC,,,outpatient,,,57.5,37.38,,38.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,51.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,16.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,46,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,43.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,16.26,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,15.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,54.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,48.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,34.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,15.39,54.63,
ASPIRATION &/OR INJ GANGLION CYST,9020612,CDM,360,RC,,,outpatient,,,570.5,370.83,,382.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,513.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,158.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,456.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,427.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,161.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,152.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,541.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,484.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,342.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,152.72,541.98,
REMOVAL IMPLANT; DEEP,9020680,CDM,360,RC,,,outpatient,,,433,281.45,,290.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,389.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,120.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,346.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,324.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,122.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,411.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,368.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,115.91,411.35,
REMOVAL UNDER ANESTH EXT FIXATION SYSTEM,9020694,CDM,360,RC,,,outpatient,,,4855.5,3156.08,,3253.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1299.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3544.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4369.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1351.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3884.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3641.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1373.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1299.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4612.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1325.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4127.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2913.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2913.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1325.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1299.82,4612.73,
EXCISION TUMOR SOFT TSS FACE/SCALP SQ 2+,9021012,CDM,360,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
I & D ABCESS HEMATOMA SOFT TISS NCK/THO,9021501,CDM,360,RC,,,outpatient,,,4118,2676.7,,2759.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1102.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3006.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3706.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1146.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3294.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3088.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1164.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1102.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3912.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1124.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3500.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2470.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2470.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1124.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1102.39,3912.1,
BIOPSY SOFT TISSUE NECK/THORAX,9021550,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
"EXCISION TUMOR, SOFT TISSUE NECK OR THOR",9021552,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
"EXCISION TUMOR, SOFT TISSUE NECK OR THOR",9021555,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
"EXCISION TUMOR, SOFT TISSUE; DEEP IM",9021556,CDM,360,RC,,,outpatient,,,638,414.7,,427.46,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,170.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,465.74,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,574.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,177.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,510.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,478.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,180.43,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,170.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,606.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,174.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,542.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,382.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,178.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,382.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.79,606.1,
EXCISION TUMOR SOFT TISS BACK/FLANK < 3C,9021930,CDM,360,RC,,,outpatient,,,5695,3701.75,,3815.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1594.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1524.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1594.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4157.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5125.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1585.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4556,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4271.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1610.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1524.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1594.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5410.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1555.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4840.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3417,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1594.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3417,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1555.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1524.55,5410.25,
EXCISION TUMOR SOFT TISS BACK/FLANK,9021931,CDM,360,RC,,,outpatient,,,588,382.2,,393.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,164.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,157.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,164.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,429.24,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,529.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,163.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,470.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,441,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,166.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,157.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,164.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,558.6,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,160.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,499.8,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,352.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,352.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,157.41,558.6,
"EXCISION ABD WALL TUMOR, SUBFASCIAL",9022900,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
EXCISION TUMOR SOFT TISSUE ABD WALL <3cm,9022902,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
EXCISION SOFT TISS ABD WALL 3cm/GREAT,9022903,CDM,360,RC,,,outpatient,,,5695,3701.75,,3815.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1594.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1524.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1594.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4157.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5125.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1585.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4556,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4271.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1610.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1524.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1594.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5410.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1555.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4840.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3417,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1594.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3417,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1555.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1524.55,5410.25,
BX SFT TISS SHLDR SUPERFICIAL,9023065,CDM,360,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
"EXCISION, SOFT TISSUE TUMOR, SHOULD;SUBC",9023075,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
CORACOACROMIAL LIGAMENT RELEASE,9023415,CDM,360,RC,,,outpatient,,,10730.5,6974.83,,7189.44,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3004.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2872.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3004.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7833.27,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9657.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2987.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8584.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8047.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3034.59,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2872.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3004.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10193.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2930,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9120.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6438.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3004.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6438.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2930,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2872.55,10193.98,
INCISION & DRAINAGE UPPER ARM ELB BU,9023931,CDM,360,RC,,,outpatient,,,2265.5,1472.58,,1517.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1653.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2038.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,630.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1812.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1699.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,640.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2152.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1925.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,606.47,2152.23,
BX DEEP UPPER ARM OR ELBOW,9024066,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
"EXCISION,TUMOR,SOFT TISSUE UPPER ARM/ELB",9024075,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
EXCISION R SUPERIOR POST BRACHIAL CYST,9024076,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
"EXCISION, OLECRANON BURSA",9024105,CDM,360,RC,,,outpatient,,,4855.5,3156.08,,3253.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1299.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3544.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4369.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1351.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3884.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3641.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1373.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1299.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4612.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1325.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4127.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2913.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2913.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1325.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1299.82,4612.73,
REMOVAL FOREIGN BODY UPPER ARM ELBOW DEE,9024201,CDM,360,RC,,,outpatient,,,433,281.45,,290.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,316.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,389.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,120.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,346.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,324.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,122.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,115.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,411.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,368.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,115.91,411.35,
OPEN TX ULNAR FX; W W/O FIXATION,9024685,CDM,360,RC,,,outpatient,,,11748.5,7636.53,,7871.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3289.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3145.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3289.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8576.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10573.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3270.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9398.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8811.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3322.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3145.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3289.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11161.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3207.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9986.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7049.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3289.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7049.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3207.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3145.07,11161.08,
"EXCISION,TUMOR,SOFT TISSUE FOREARM/WRIST",9025075,CDM,360,RC,,,outpatient,,,898,583.7,,601.66,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,251.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,240.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,251.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,655.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,808.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,250.01,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,718.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,673.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,253.95,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,240.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,251.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,853.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,245.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,763.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,538.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,251.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,538.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,245.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.39,853.1,
"EXCISION, TUMOR, SOFT TISS FOREARM/WRIST",9025076,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
"EXCISION OF GANGLION, WRIST; PRIMARY",9025111,CDM,360,RC,,,outpatient,,,391,254.15,,261.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,109.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,104.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,285.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,351.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,108.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,312.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,293.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,110.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,104.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,109.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,371.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,106.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,332.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,104.67,371.45,
RADICAL EXCISION BURSA/SYNOVIA/TENDON SH,9025116,CDM,360,RC,,,outpatient,,,4855.5,3156.08,,3253.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1299.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3544.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4369.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1351.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3884.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3641.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1373.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1299.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4612.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1325.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4127.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2913.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2913.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1325.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1299.82,4612.73,
"CLOSED TX DISTAL RADIAL FX, W/MANIPULATI",9025605,CDM,360,RC,,,outpatient,,,1245.5,809.58,,834.49,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,348.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,333.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,348.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,909.22,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1120.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,346.76,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,996.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,934.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,352.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,333.42,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,348.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1183.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,340.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1058.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,747.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,747.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,340.09,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,333.42,1183.23,
CLOSED TX CARPAL BONE FX W/O MANIPULATIO,9025630,CDM,360,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
DRAINAGE FINGER ABSCESS; SIMPLE,9026010,CDM,360,RC,,,outpatient,,,235.2,152.88,,157.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,65.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,62.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,171.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,211.68,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,65.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,188.16,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,176.4,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,66.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,62.96,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,65.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,223.44,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,64.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,199.92,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,141.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,141.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,62.96,223.44,
DRAINAGE FINGER ABSCESS; COMPLICATED,9026011,CDM,360,RC,,,outpatient,,,283,183.95,,189.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,206.59,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,254.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,78.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,226.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,212.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,80.03,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,75.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,268.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,240.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.24,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.28,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,75.76,268.85,
"FASCIOTOMY,PALMAR; OPEN,PARTIAL",9026045,CDM,360,RC,,,outpatient,,,6448.5,4191.53,,4320.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1805.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1726.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1805.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4707.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5803.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1795.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5158.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4836.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1823.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1726.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1805.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6126.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1760.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5481.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3869.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1805.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3869.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1760.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1726.26,6126.08,
TENDON SHEATH INCISION,9026055,CDM,360,RC,,,outpatient,,,3701,2405.65,,2479.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2701.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3330.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1030.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2960.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2775.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1046.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3515.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3145.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,990.76,3515.95,
ARTHROTOMY W/BIOPSY; INTERPHALANGEAL JT,9026110,CDM,360,RC,,,outpatient,,,3701,2405.65,,2479.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2701.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3330.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1030.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2960.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2775.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1046.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3515.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3145.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,990.76,3515.95,
EXC TUMOR SFT TSS HAND/FING SUBQ 1.5cm,9026111,CDM,360,RC,,,outpatient,,,3861,2509.65,,2586.87,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1081.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1033.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1081.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2818.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3474.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1074.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3088.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2895.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1091.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1033.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1081.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3667.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1054.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3281.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2316.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1081.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2316.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1054.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1033.59,3667.95,
"EXCISION, TUMOR, HAND/FINGER, SUBCU",9026115,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
"EXCISION, TUMOR, SOFT TISSUE HAND OR FIN",9026116,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
FASCIECTOMY PART PALM W/REL SGLE DIGIT,9026123,CDM,360,RC,,,outpatient,,,6448.5,4191.53,,4320.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1805.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1726.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1805.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4707.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5803.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1795.31,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5158.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4836.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1823.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1726.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1805.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6126.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1760.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5481.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3869.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1805.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3869.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1760.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1726.26,6126.08,
"SYNOVECTOMY,TENDON SHEATH, RADICAL",9026145,CDM,360,RC,,,outpatient,,,3701,2405.65,,2479.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2701.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3330.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1030.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2960.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2775.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1046.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3515.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3145.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,990.76,3515.95,
EXCISION LESION TENDON SHEATH/JOINT,9026160,CDM,360,RC,,,outpatient,,,383.5,249.28,,256.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,107.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,102.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,107.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,279.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,345.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,106.77,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,306.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,287.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,108.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,102.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,107.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,364.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,104.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,325.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,230.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,230.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,102.66,364.33,
PARTIAL EXCISION OF BONE;DISTAL PHALANX,9026236,CDM,360,RC,,,outpatient,,,3701,2405.65,,2479.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2701.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3330.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1030.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2960.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2775.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1046.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3515.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3145.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,990.76,3515.95,
REPAIR EXT TENDON WO FREE GRF,9026418,CDM,360,RC,,,outpatient,,,3701,2405.65,,2479.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2701.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3330.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1030.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2960.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2775.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1046.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3515.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3145.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,990.76,3515.95,
"TENOTOMY,FLEXOR,FINGER,OPEN,EA TENDON",9026455,CDM,360,RC,,,outpatient,,,3701,2405.65,,2479.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2701.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3330.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1030.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2960.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2775.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1046.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,990.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3515.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3145.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1036.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2220.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.58,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,990.76,3515.95,
"CLOSED TX METACARPAL FX, SINGLE; W/MANIP",9026605,CDM,360,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
"OPEN TX METACARPAL FX, SINGLE, W W/O FIX",9026615,CDM,360,RC,,,outpatient,,,11748.5,7636.53,,7871.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3289.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3145.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3289.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8576.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10573.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3270.87,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9398.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8811.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3322.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3145.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3289.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11161.08,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3207.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9986.23,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,7049.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3289.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7049.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3207.97,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3145.07,11161.08,
"OPEN TX DIXTAL PHALANGEAL FX, EACH",9026765,CDM,360,RC,,,outpatient,,,5959,3873.35,,3992.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4350.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5363.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1659.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4767.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4469.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1685.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5661.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5065.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1595.22,5661.05,
BIOPSY SOFT TISSUE PELVIS HIP 3cm OR >,9027043,CDM,360,RC,,,outpatient,,,1070.5,695.83,,717.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,299.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,299.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,781.47,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,963.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,298.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,856.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,802.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,302.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,286.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,299.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1016.98,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,292.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,909.93,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,642.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,299.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,642.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,286.57,1016.98,
"I & D, DEEP ABSCESS,BURSA,HEMATOMA;THIGH",9027301,CDM,360,RC,,,outpatient,,,4118,2676.7,,2759.06,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1102.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3006.14,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3706.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1146.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3294.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3088.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1164.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1102.39,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3912.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1124.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3500.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2470.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1153.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2470.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1124.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1102.39,3912.1,
BIOPSY SOFT TISSUE THIGH/KNEE,9027323,CDM,360,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
EXCISION SYNOVIAL CYST POPLITEAL SPACE,9027345,CDM,360,RC,,,outpatient,,,4855.5,3156.08,,3253.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1299.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3544.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4369.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1351.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3884.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3641.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1373.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1299.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4612.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1325.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4127.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2913.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1359.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2913.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1325.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1299.82,4612.73,
CLOSED TX FEMORAL FX,9027503,CDM,360,RC,,,outpatient,,,418.5,272.03,,280.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,305.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,376.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,116.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,334.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,313.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,118.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,112.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,397.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,355.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117.18,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,251.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,112.03,397.58,
AMPUTATION THIGH THROUGH FEMUR (IP ONLY),9027590,CDM,360,RC,,,outpatient,,,2473.5,1607.78,,1657.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,692.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,662.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,692.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1805.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2226.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,688.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1978.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1855.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,699.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,662.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,692.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2349.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,675.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2102.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1484.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,692.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1484.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,675.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,662.16,2349.83,
AMPUTATION THIGH/FEMOR  (IP ONLY),9027596,CDM,360,RC,,,outpatient,,,2473.5,1607.78,,1657.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,692.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,662.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,692.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1805.66,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2226.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,688.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1978.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1855.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,699.51,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,662.16,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,692.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2349.83,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,675.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2102.48,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1484.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,692.58,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1484.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,675.4,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,662.16,2349.83,
RE-AMPUTATION OF LEG,9027886,CDM,360,RC,,,outpatient,,,2041.5,1326.98,,1367.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,571.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,546.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,571.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1490.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1837.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,568.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1531.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,577.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,546.51,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,571.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1939.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,557.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1735.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1224.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,571.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1224.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,557.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,546.51,1939.43,
"FASCIOTOMY, FOOT AND/OR TOE",9028008,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
"ARTHROTOMY,INCLUD EXPLOR DRAIN REM FB",9028022,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
EXCISION TUMOR FOOT/TOE SUBQ 1.5+cm,9028039,CDM,360,RC,,,outpatient,,,5185,3370.25,,3473.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3785.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4666.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1443.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4148,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3888.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1466.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1388.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4925.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4407.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1451.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1415.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1388.02,4925.75,
"EXCISION, TUMOR, FOOT; SUBCU TISSUE",9028043,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
EXC TUM FOOT OR TOE SUBFASCIAL<1.5 CM,9028045,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
FASCIECTOMY PLANTR PART,9028060,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
"EXCISION INTERDIGITAL NEUROMA, SINGLE EA",9028080,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
EXCISION CYST/GANGLION FOOT,9028090,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
EXCISION LESION TEND/SHEATH; TOE,9028092,CDM,360,RC,,,outpatient,,,2967,1928.55,,1987.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,830.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,794.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,830.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2165.91,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2670.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,826.04,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2373.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2225.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,839.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,794.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,830.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2818.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,810.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2521.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1780.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,830.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1780.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,810.16,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,794.27,2818.65,
EXCISION BONE CYST OR BENIGN TUMOR,9028104,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
EXC BONE CYST BENGN TUM PHALANGES FOOT,9028108,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
PARTIAL EXCISION BONE; PHALANX OF TOE,9028124,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
RESECTION PART OR COMPL PHALANGEAL BASE,9028126,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
"REMOVAL FOREIGN BODY, FOOT; SUBCUTANEOUS",9028190,CDM,360,RC,,,outpatient,,,1823,1184.95,,1221.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1330.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1640.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,507.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1458.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1367.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,515.54,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,488.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1731.85,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1549.55,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1093.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,497.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,488.02,1731.85,
"REMOVAL FOREIGN BODY, FOOT; DEEP",9028192,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
REPAIR FLXR TNDN SECND W/GRF,9028202,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
"REPAIR TENDON,EXTENSOR,FOOT;PRIM/SEC @ T",9028208,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
TENOLYSIS EXTENSOR FOOT SINGLE,9028225,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
"CORRECTION, HAMMERTOE",9028285,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
"OSTECTOMY,PARTIAL,EXOSTECTOMY @ META HEA",9028288,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
REPAIR HALLUX RIGIDUS W/CHEILECTOMY,9028289,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
HALLUX VALGUS CORRECT SIMPLE,9028290,CDM,360,RC,,,outpatient,,,7664.5,4981.93,,5135.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2146.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2051.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2146.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5595.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6898.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2133.86,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6131.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5748.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2167.52,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2051.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2146.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7281.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2092.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6514.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4598.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2146.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4598.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2092.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2051.79,7281.28,
"OSTEOTOMY, W W/O LENTH/SHORT METATARSAL",9028308,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
OPEN TX CALCANEAL FX W OR W/O FIXATION,9028415,CDM,360,RC,,,outpatient,,,15732.5,10226.13,,10540.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4405.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4211.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4405.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11484.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14159.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4380.05,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12586,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11799.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4449.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4211.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4405.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,14945.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4295.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13372.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9439.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4405.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9439.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4295.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4211.59,14945.88,
"AMPUTATION,FOOT;TRANSMETATARSAL",9028805,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
"AMPUTATION METATARSAL W/TOE, SINGLE",9028810,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
AMPUTATION TOE METATARSOPHALANGEAL JOINT,9028820,CDM,360,RC,,,outpatient,,,4945,3214.25,,3313.15,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3609.85,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4450.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1376.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3956,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3708.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1398.45,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1323.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4697.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4203.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1384.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2967,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1350.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.78,4697.75,
APPLICATION LONG LEG CAST,9029345,CDM,360,RC,,,outpatient,,,591,384.15,,395.97,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,165.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,158.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,165.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,431.43,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,531.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,164.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,472.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,443.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,167.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,158.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,165.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,561.45,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,161.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,502.35,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,354.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165.48,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,354.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,158.21,561.45,
"ARTHROSCOPY KNEE, DIAGNOSTIC WorW/O SYN",9029870,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
"ARTHROSCOPY, KNEE, REMOVAL LOOSE/FB",9029874,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
"ARTHROSCOPY, KNEE, SYNOVECTOMY, LIMITED",9029875,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
"ARTHROSCOPY, KNEE, SYNOVECTOMY, MAJOR",9029876,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
"ARTHROSCOPY, KNEE, DEBRIDEMENT/SHAVING",9029877,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
ARTHROSCOPY KNEE;ABRASION ARTHROPLASTY,9029879,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
"ARTHROSCOPY, KNEE, W/MENISC MED & LAT",9029880,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
"ARTHROSCOPY, KNEE, WITH MENISCECTOMY",9029881,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
UNLISTED ARTHROSCOPY,9029999,CDM,360,RC,,,outpatient,,,6591.5,4284.48,,4416.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4811.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5932.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1835.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4943.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1864.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1764.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6261.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5602.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1845.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1799.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1764.54,6261.93,
REMOVAL FOREIGN BODY INTRANASAL,9030300,CDM,360,RC,,,outpatient,,,135.5,88.08,,90.79,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,37.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,36.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,98.92,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,121.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,37.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,108.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,101.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,38.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,36.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,37.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,128.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,115.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,81.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,81.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,36.27,128.73,
"SINUSOTOMY, SPHENOID, WorW/O BIOP;W/MUC",9031051,CDM,360,RC,,,outpatient,,,10235,6652.75,,6857.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2865.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2739.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2865.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7471.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9211.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2849.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8188,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7676.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2894.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2739.91,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2865.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9723.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2794.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8699.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6141,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2865.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6141,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2794.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2739.91,9723.25,
BRONCHOSCOPY FLEXIBLE; DIAGNOSTIC,9031622,CDM,360,RC,,,outpatient,,,2385,1550.25,,1597.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,667.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,638.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,667.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1741.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2146.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,664,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1908,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1788.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,674.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,638.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,667.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2265.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,651.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2027.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1431,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,667.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1431,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,651.23,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,638.46,2265.75,
"THORACENTESIS, PUNCTURE OF PLEURAL CAVIT",9032554,CDM,360,RC,,,outpatient,,,1287.5,836.88,,862.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,939.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1158.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,358.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1030,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,965.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,364.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1223.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1094.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,344.66,1223.13,
REPAIR BLOOD VESSEL UPPER EXTREMITY,9035206,CDM,360,RC,,,outpatient,,,6709,4360.85,,4495.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1878.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1796,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1878.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4897.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6038.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1867.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5367.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5031.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1897.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1796,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1878.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6373.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1831.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5702.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4025.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1878.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4025.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1831.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1796,6373.55,
EXPLORE POSTOP HEMORRHAGE; EXTREMITY,9035860,CDM,360,RC,,,outpatient,,,6709,4360.85,,4495.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1878.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1796,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1878.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4897.57,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6038.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1867.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5367.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5031.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1897.31,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1796,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1878.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6373.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1831.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5702.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4025.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1878.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4025.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1831.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1796,6373.55,
INSERTION NON-TUNNELED CVC 5yrs OR OLDER,9036556,CDM,360,RC,,,outpatient,,,1968.6,1279.59,,1318.96,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,526.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1437.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1771.74,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,548.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1574.88,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1476.45,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,556.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,526.99,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1870.17,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,537.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1673.31,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1181.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,551.21,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1181.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,537.53,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,526.99,1870.17,
INSERTION TUNNELED CV ACCESS W/O PORT,9036558,CDM,360,RC,,,outpatient,,,5475.5,3559.08,,3668.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1465.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3997.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4927.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1524.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4380.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4106.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1548.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1465.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5201.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1495.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4654.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3285.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3285.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1495.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1465.79,5201.73,
INSERTION TUNNELED CV ACCESS DEVICE,9036561,CDM,360,RC,,,outpatient,,,6954.5,4520.43,,4659.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1947.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1861.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1947.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5076.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6259.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1936.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5563.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5215.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1966.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1861.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1947.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6606.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1898.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5911.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4172.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1947.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4172.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1898.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1861.72,6606.78,
INSERTION PERIPHERAL CVCw/PORT AGE 5>,9036571,CDM,360,RC,,,outpatient,,,5475.5,3559.08,,3668.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1465.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3997.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4927.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1524.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4380.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4106.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1548.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1465.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5201.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1495.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4654.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3285.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3285.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1495.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1465.79,5201.73,
REPLACEMENT CATHETER ONLY CVA DEVICE,9036578,CDM,360,RC,,,outpatient,,,5475.5,3559.08,,3668.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1465.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3997.12,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4927.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1524.42,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4380.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4106.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1548.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1465.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5201.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1495.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4654.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3285.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1533.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3285.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1495.11,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1465.79,5201.73,
"REPLACEMENT, COMPLETE, CVC W/SQ PORT",9036582,CDM,360,RC,,,outpatient,,,6954.5,4520.43,,4659.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1947.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1861.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1947.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5076.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6259.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1936.19,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,5563.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5215.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1966.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1861.72,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1947.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6606.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1898.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5911.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4172.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1947.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4172.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1898.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1861.72,6606.78,
REM OF TUN CENT VEN CATH W/O PORT,9036589,CDM,360,RC,,,outpatient,,,1373,892.45,,919.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,384.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1002.29,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1235.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,382.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1098.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1029.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,388.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,367.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1304.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,374.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1167.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,823.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,384.44,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,823.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,374.9,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,367.55,1304.35,
REMOVAL CENTRAL VENOUS ACCESS DEVICE,9036590,CDM,360,RC,,,outpatient,,,2454.5,1595.43,,1644.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,657.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1791.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2209.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,683.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1963.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1840.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,694.13,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,657.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2331.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,670.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2086.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1472.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,687.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1472.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,670.21,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,657.07,2331.78,
LIGATION OR BIOPSY TEMPORAL ARTERY,9037609,CDM,360,RC,,,outpatient,,,3502,2276.3,,2346.34,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2556.46,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3151.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,974.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2801.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2626.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,990.37,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,937.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3326.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2976.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,980.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2101.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,956.24,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,937.49,3326.9,
BIOPSY OR EXCISION OF LYMPH NODE; OPEN,9038500,CDM,360,RC,,,outpatient,,,5681.5,3692.98,,3806.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1520.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4147.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5113.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1581.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4545.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4261.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1606.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1520.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5397.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1551.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4829.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1551.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1520.94,5397.43,
BIOPSY OR EXCISION OF LYMPH NODE(S); OPE,9038510,CDM,360,RC,,,outpatient,,,5681.5,3692.98,,3806.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1520.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4147.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5113.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1581.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4545.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4261.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1606.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1520.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5397.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1551.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4829.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1551.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1520.94,5397.43,
BIOPSY OR EXCISION LYMPH NODE(S); OPEN D,9038520,CDM,360,RC,,,outpatient,,,5681.5,3692.98,,3806.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1520.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4147.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5113.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1581.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4545.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4261.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1606.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1520.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5397.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1551.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4829.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1551.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1520.94,5397.43,
BIOPSY/EXCISION LYMPH NODE AXILLARY,9038525,CDM,360,RC,,,outpatient,,,5681.5,3692.98,,3806.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1520.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4147.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5113.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1581.78,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4545.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4261.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1606.73,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1520.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5397.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1551.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4829.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1590.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1551.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1520.94,5397.43,
DISSECTION DEEP JUGULAR NODE(S),9038542,CDM,360,RC,,,outpatient,,,11459,7448.35,,7677.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3208.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3067.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3208.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8365.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,10313.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3190.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,9167.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8594.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3240.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3067.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3208.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10886.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3128.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9740.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6875.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3208.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6875.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3128.92,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3067.57,10886.05,
EXCIS LES MOUTH W SIMP REPAIR,9040812,CDM,360,RC,,,outpatient,,,2148.9,1396.79,,1439.76,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,601.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,575.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,601.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1568.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1934.01,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,598.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1719.12,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1611.68,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,607.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,575.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,601.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2041.46,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,586.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1826.57,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1289.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,601.69,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1289.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,586.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,575.26,2041.46,
INCISION OF LINGUAL FRENUM,9041010,CDM,360,RC,,,outpatient,,,1557,1012.05,,1043.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,435.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1136.61,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1401.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,433.48,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1245.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1167.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,440.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,416.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1479.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,425.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1323.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,934.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,435.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,934.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,425.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,416.81,1479.15,
EXCISION LESION TONGUE W/CLOSURE ANT 2/3,9041112,CDM,360,RC,,,outpatient,,,3581.5,2327.98,,2399.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1002.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,958.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1002.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2614.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3223.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,997.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2865.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2686.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1012.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,958.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1002.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3402.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,977.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3044.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2148.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1002.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2148.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,977.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,958.77,3402.43,
EXCISION LESION TONGUE W/CLOSURE POST 1/,9041113,CDM,360,RC,,,outpatient,,,3581.5,2327.98,,2399.61,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1002.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,958.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1002.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2614.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3223.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,997.12,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2865.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2686.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1012.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,958.77,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1002.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3402.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,977.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3044.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2148.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1002.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2148.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,977.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,958.77,3402.43,
INCISION & DRAINAGE ABSCESS PERITONEAL,9042700,CDM,360,RC,,,outpatient,,,815,529.75,,546.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,228.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,218.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,228.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,594.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,733.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,226.91,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,652,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,611.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,230.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,218.18,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,228.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,774.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,222.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,692.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,489,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,489,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,218.18,774.25,
TONSILLECTOMY & ADENOIDECTOMY; < AGE 12,9042820,CDM,360,RC,,,outpatient,,,5617.5,3651.38,,3763.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1503.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4100.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5055.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1563.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4494,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4213.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1588.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1503.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5336.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1533.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4774.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3370.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3370.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1533.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1503.8,5336.63,
TONSILLECTOMY & ADENOIDECTOMY; > AGE 12,9042821,CDM,360,RC,,,outpatient,,,5617.5,3651.38,,3763.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1503.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4100.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5055.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1563.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4494,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4213.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1588.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1503.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5336.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1533.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4774.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3370.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3370.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1533.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1503.8,5336.63,
"TONSILLECTOMY,PRIMARY/SECONDARY; 12 OR <",9042825,CDM,360,RC,,,outpatient,,,1017.5,661.38,,681.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,284.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,272.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,284.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,742.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,915.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,283.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,814,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,763.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,287.75,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,272.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,284.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,966.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,277.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,864.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,610.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,610.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,272.38,966.63,
"TONSILLECTOMY,PRIMARY/SECONDARY; 12 OR >",9042826,CDM,360,RC,,,outpatient,,,5617.5,3651.38,,3763.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1503.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4100.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5055.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1563.95,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4494,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4213.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1588.63,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1503.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5336.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1533.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4774.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3370.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1572.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3370.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1533.88,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1503.8,5336.63,
ESOPHAGOSCOPY RIGID W BALLOON,9043195,CDM,360,RC,,,outpatient,,,3324.5,2160.93,,2227.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,930.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,889.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,930.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2426.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2992.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,925.57,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2659.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2493.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,940.17,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,889.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,930.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3158.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,907.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2825.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1994.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930.86,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1994.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,889.97,3158.28,
"ESOPHAGOSCOPY, RIGID OR FLEX; DIAGNOSTIC",9043200,CDM,360,RC,,,outpatient,,,175,113.75,,117.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,46.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.75,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,157.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,48.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,140,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,131.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,49.49,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,46.85,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,166.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,47.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,148.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,46.85,166.25,
ESOPHAGOSCOPY DILATE BALLOON 30MM,9043214,CDM,360,RC,,,outpatient,,,4455.5,2896.08,,2985.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1247.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1192.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1247.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3252.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4009.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1240.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3564.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3341.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1260.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1192.74,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1247.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4232.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1216.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3787.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2673.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1247.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2673.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1216.59,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1192.74,4232.73,
UPPER GI ENDO W/DIRECTED PLACE G-TUBE,9043246,CDM,360,RC,,,outpatient,,,1735.8,1128.27,,1162.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,464.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1267.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1562.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,483.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1388.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1301.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,490.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,464.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1649.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,473.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1475.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1041.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1041.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,473.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,464.67,1649.01,
UPPER GI ENDO REMOVE FB,9043247,CDM,360,RC,,,outpatient,,,1946.5,1265.23,,1304.16,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,545.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,521.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,545.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1420.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1751.85,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,541.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1557.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1459.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,550.47,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,521.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,545.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1849.18,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,531.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1654.53,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1167.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,545.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1167.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,531.5,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,521.08,1849.18,
UGI W/BALLOON DILATION OF ESOPHAGUS,9043249,CDM,360,RC,,,outpatient,,,1735.8,1128.27,,1162.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,464.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1267.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1562.22,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,483.26,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1388.64,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1301.85,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,490.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,464.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1649.01,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,473.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1475.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1041.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,486.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1041.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,473.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,464.67,1649.01,
ESOPHAGOSCOPY W/ABALATION,9043258,CDM,360,RC,,,outpatient,,,2893,1880.45,,1938.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,774.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2111.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2603.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,805.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2314.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2169.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,818.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,774.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2748.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,789.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2459.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1735.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1735.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,789.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,774.46,2748.35,
DILATE ESOPH UNGUIDED SOUND,9043450,CDM,360,RC,,,outpatient,,,200,130,,134,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,180,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.68,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,160,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,150,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.54,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.61,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.54,190,
DILATION OF ESOPHAGUS BALLOON  30mm DIAM,9043458,CDM,360,RC,,,outpatient,,,2893,1880.45,,1938.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,774.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2111.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2603.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,805.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2314.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2169.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,818.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,774.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2748.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,789.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2459.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1735.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1735.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,789.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,774.46,2748.35,
VAGOTOMY INCL PYLOROPLASTY (IP ONLY),9043640,CDM,360,RC,,,outpatient,,,3549,2306.85,,2377.83,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,993.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,950.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,993.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2590.77,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3194.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,988.07,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2839.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2661.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1003.66,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,950.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,993.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3371.55,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,969.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3016.65,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2129.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,993.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2129.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,969.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,950.07,3371.55,
CHANGE OF GASTROSTOMY TUBE,9043760,CDM,360,RC,,,outpatient,,,540,351,,361.8,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,151.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,144.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,151.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,394.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,486,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,150.34,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,432,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,405,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,152.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,144.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,151.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,513,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,147.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,459,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,324,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,151.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,324,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.45,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,144.56,513,
"GASTROSTOMY, OPEN; W/O CONSTRUCT G TUBE",9043830,CDM,360,RC,,,outpatient,,,5829.5,3789.18,,3905.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1632.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1560.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1632.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4255.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5246.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1622.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4663.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4372.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1648.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1560.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1632.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5538.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1591.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4955.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3497.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1632.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3497.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1591.77,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1560.56,5538.03,
ENTEROLYSIS (I/P PROCEDURE ONLY),9044005,CDM,360,RC,,,outpatient,,,2013,1308.45,,1348.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,563.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,538.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,563.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1469.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1811.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,560.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1610.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1509.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,569.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,538.88,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,563.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1912.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,549.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1711.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1207.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,563.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1207.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,549.66,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,538.88,1912.35,
ENTERECTOMY RESECT SM INTEST (IP ONLY),9044120,CDM,360,RC,,,outpatient,,,3683.5,2394.28,,2467.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1031.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,986.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1031.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2688.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3315.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1025.51,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2946.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2762.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1041.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,986.07,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1031.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3499.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1005.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3130.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2210.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1031.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2210.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1005.79,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,986.07,3499.33,
MOBILIZATION SPENIC FLEXURE WITH PART CO,9044139,CDM,360,RC,,,outpatient,,,387,251.55,,259.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,108.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,103.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,108.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,282.51,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,348.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,107.74,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,309.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,290.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,109.44,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,103.6,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,108.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,105.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,328.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,232.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.36,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,232.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.67,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,103.6,367.65,
COLECTOMY PARTIAL W ANASTOMOSIS (IP ONLY,9044140,CDM,360,RC,,,outpatient,,,4224,2745.6,,2830.08,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1182.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1130.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1182.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3083.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3801.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1175.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3379.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3168,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1194.55,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1130.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1182.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4012.8,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1153.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3590.4,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2534.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2534.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1153.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1130.76,4012.8,
SMALL BOWEL ENDOSCOPY,9044376,CDM,360,RC,,,outpatient,,,1092,709.8,,731.64,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,305.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,292.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,305.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,797.16,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,982.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,304.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,873.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,819,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,308.82,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,292.33,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,305.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1037.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,298.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,928.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,655.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,305.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,655.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,298.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,292.33,1037.4,
COLONOSCOPY THROUGH STOMA;W/BIOPSY,9044389,CDM,360,RC,,,outpatient,,,2158.5,1403.03,,1446.2,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,604.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,577.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,604.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1575.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1942.65,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,600.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1726.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1618.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,610.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,577.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,604.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2050.58,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,589.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1834.73,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1295.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1295.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,589.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,577.83,2050.58,
APPENDECTOMY,9044950,CDM,360,RC,,,outpatient,,,5783.5,3759.28,,3874.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1548.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4221.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5205.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1610.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4626.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4337.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1635.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1548.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5494.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1579.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4915.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3470.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3470.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1579.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1548.24,5494.33,
APPENDECTOMY RUPT W/ABSC (IP ONLY),9044960,CDM,360,RC,,,outpatient,,,2630,1709.5,,1762.1,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,736.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,704.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,736.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1919.9,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2367,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,732.21,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2104,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1972.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,743.76,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,704.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,736.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2498.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,718.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2235.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1578,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,736.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1578,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,718.13,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,704.05,2498.5,
APPENDECTOMY; LAPAROSCOPY,9044970,CDM,360,RC,,,outpatient,,,10884.5,7074.93,,7292.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7945.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9796.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3030.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8707.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8163.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3078.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10340.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9251.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2913.78,10340.28,
"PROCTOSIGMOIDOSCOPY,RIGID;DIAGNOSTIC",9045300,CDM,360,RC,,,outpatient,,,1313,853.45,,879.71,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,367.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,351.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,367.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,958.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1181.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,365.55,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1050.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,984.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,371.32,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,351.49,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,367.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1247.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,358.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1116.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,787.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,367.64,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,787.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,358.52,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,351.49,1247.35,
"SIGMOIDSCOPY; FLEXIBLE; DIAG, W/C BLEED",9045334,CDM,360,RC,,,outpatient,,,353,229.45,,236.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,98.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,257.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,317.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,98.28,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,282.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,264.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,99.83,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,94.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,335.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,96.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,300.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,211.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,98.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,211.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,94.5,335.35,
"SIGMOIDOSCOPY, FLEXIBLE;W/REMOVAL",9045338,CDM,360,RC,,,outpatient,,,2234,1452.1,,1496.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,625.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,598.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,625.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1630.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2010.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,621.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1787.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1675.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,631.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,598.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,625.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2122.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,610,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1898.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1340.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,625.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1340.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,610,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,598.04,2122.3,
"SIGMOIDOSCOPY, FLEXIBLE",9045339,CDM,360,RC,,,outpatient,,,2234,1452.1,,1496.78,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,625.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,598.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,625.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1630.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2010.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,621.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1787.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1675.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,631.78,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,598.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,625.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2122.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,610,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1898.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1340.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,625.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1340.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,610,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,598.04,2122.3,
COLONOSCOPY w/DIRECT SUBMUC INJECT,9045381,CDM,360,RC,,,outpatient,,,1479.3,961.55,,991.13,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,414.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,396.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,414.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1079.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1331.37,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,411.85,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1183.44,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1109.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,418.35,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,396.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,414.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1405.34,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,403.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1257.41,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,887.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,414.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,887.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,403.93,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,396.01,1405.34,
COLONOSCOPY FLEX DIAG W CONTROL OF BLEED,9045382,CDM,750,RC,,,outpatient,,,1295,841.75,,867.65,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,362.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,346.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,362.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,945.35,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1165.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,360.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1036,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,971.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,366.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,346.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,362.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1230.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,353.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1100.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,777,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,777,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,346.67,1230.25,
COLONOSCOPY FLEX W BALLOON DILATION,9045386,CDM,360,RC,,,outpatient,,,1754.1,1140.17,,1175.25,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,491.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,469.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,491.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1280.49,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1578.69,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,488.35,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1403.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1315.58,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,496.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,469.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,491.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1666.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,478.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1490.99,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1052.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,491.15,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1052.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,478.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,469.57,1666.4,
COLONSCOPY FLEXIBLE W/BAND LIGATION,9045398,CDM,360,RC,,,outpatient,,,352.5,229.13,,236.18,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,98.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,94.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,257.33,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,317.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,98.13,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,282,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,264.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,99.69,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,94.36,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,98.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,334.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,96.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,299.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,211.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,98.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,211.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.25,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,94.36,334.88,
DILATION OF ANAL SPHINCTER,9045905,CDM,360,RC,,,outpatient,,,3992.5,2595.13,,2674.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2914.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3593.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1111.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3194,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2994.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1129.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3792.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3393.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1068.79,3792.88,
I & D PERIRECTAL ABSCESS,9046040,CDM,360,RC,,,outpatient,,,3992.5,2595.13,,2674.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2914.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3593.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1111.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3194,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2994.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1129.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3792.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3393.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1068.79,3792.88,
INCISION & DRAINAGE PERIANAL ABSCESS,9046050,CDM,360,RC,,,outpatient,,,1372,891.8,,919.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1001.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1234.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,381.97,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1097.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1029,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,388,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,367.28,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1303.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,374.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1166.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,823.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,384.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,823.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,374.63,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,367.28,1303.4,
"SPHINCTEROTOMY, ANAL",9046080,CDM,360,RC,,,outpatient,,,3992.5,2595.13,,2674.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2914.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3593.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1111.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3194,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2994.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1129.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3792.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3393.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1068.79,3792.88,
PAPILLECTOMY OR EXCISION SINGLE TAG ANUS,9046220,CDM,360,RC,,,outpatient,,,3992.5,2595.13,,2674.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2914.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3593.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1111.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3194,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2994.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1129.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3792.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3393.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1068.79,3792.88,
HEMORRHOIDECTOMY BY SIMPLE LIGATURE,9046221,CDM,360,RC,,,outpatient,,,685,445.25,,458.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,191.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,183.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,191.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,500.05,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,616.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,190.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,548,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,513.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,193.72,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,183.37,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,191.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,650.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,187.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,582.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,411,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,191.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,411,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,187.04,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,183.37,650.75,
EXCISION EXT HEMORRHOID TAGS/MULT PAPIL,9046230,CDM,360,RC,,,outpatient,,,3992.5,2595.13,,2674.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2914.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3593.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1111.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3194,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2994.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1129.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3792.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3393.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1068.79,3792.88,
"HEMORRHOIDECTOMY, INTERNAL & EXT, SIMPLE",9046255,CDM,360,RC,,,outpatient,,,1427.5,927.88,,956.43,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,399.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,382.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,399.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1042.08,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1284.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,397.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1142,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1070.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,403.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,382.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,399.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1356.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,389.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1213.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,856.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,399.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,856.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,389.78,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,382.14,1356.13,
"HEMORRHOIDECTOMY,INT/EXT, COMPLEX/EXTENS",9046260,CDM,360,RC,,,outpatient,,,5710,3711.5,,3825.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4168.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5139,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1589.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4568,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4282.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1614.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5424.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4853.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1528.57,5424.5,
"HEMORRHOIDECTOMY, COMPLEX W/FISSURE",9046261,CDM,360,RC,,,outpatient,,,5710,3711.5,,3825.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4168.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5139,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1589.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4568,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4282.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1614.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5424.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4853.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1528.57,5424.5,
SURGICAL TX ANAL FISTULA,9046270,CDM,360,RC,,,outpatient,,,5710,3711.5,,3825.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4168.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5139,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1589.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4568,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4282.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1614.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5424.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4853.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1528.57,5424.5,
"EXCISION THROMBOSED HEMORRHOID, EXT",9046320,CDM,360,RC,,,outpatient,,,3992.5,2595.13,,2674.98,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2914.53,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3593.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1111.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3194,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2994.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1129.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1068.79,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3792.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3393.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1117.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2395.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1090.17,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1068.79,3792.88,
ANOSCOPY DIAGNOSTIC,9046600,CDM,360,RC,46600,HCPCS,outpatient,,,155.5,101.08,,104.19,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,43.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,41.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,113.52,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,139.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,43.3,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,124.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,116.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,43.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,41.63,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,43.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,147.73,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,42.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,132.18,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,93.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.54,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,93.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,41.63,147.73,
DESTRUCTION OF LESION ANUS; SIMPLE,9046922,CDM,360,RC,,,outpatient,,,4426,2876.9,,2965.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1184.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3230.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3983.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1232.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3540.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3319.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1251.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1184.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4204.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1208.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3762.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2655.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2655.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1208.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1184.84,4204.7,
"DESTRUCTION LESION, ANUS, EXTENSIVE",9046924,CDM,360,RC,,,outpatient,,,4426,2876.9,,2965.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1184.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3230.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3983.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1232.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3540.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3319.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1251.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1184.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4204.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1208.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3762.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2655.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2655.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1208.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1184.84,4204.7,
LIGATION INTERNAL HEMORRHOIDS,9046945,CDM,360,RC,,,outpatient,,,5710,3711.5,,3825.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4168.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5139,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1589.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4568,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4282.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1614.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5424.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4853.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1528.57,5424.5,
HEMORRHOIDECTOMY 2 OR MORE COL GRPS,9046946,CDM,360,RC,,,outpatient,,,5710,3711.5,,3825.7,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4168.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5139,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1589.71,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4568,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4282.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1614.79,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1528.57,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5424.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4853.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1598.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3426,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1559.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1528.57,5424.5,
"UNLISTED PROCEDURE, ANUS",9046999,CDM,360,RC,,,outpatient,,,1374,893.1,,920.58,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,384.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,367.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1003.02,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1236.6,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,382.53,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1099.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1030.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,388.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,367.82,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,384.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1305.3,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,375.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1167.9,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,824.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,384.72,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,824.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,375.18,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,367.82,1305.3,
UNLISTED LAPAROSCOPIC  PROCEDURE LIVER,9047379,CDM,360,RC,,,outpatient,,,3625.5,2356.58,,2429.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1015.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,970.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1015.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2646.62,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3262.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1009.37,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2900.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2719.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1025.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,970.55,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1015.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3444.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,989.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3081.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2175.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1015.14,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2175.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,989.96,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,970.55,3444.23,
"CHOLECYSTECTOMY, LAPAROSCOPY",9047562,CDM,360,RC,,,outpatient,,,13564.5,8816.93,,9088.22,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3798.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3631.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3798.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9902.09,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,12208.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3776.47,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,10851.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,10173.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3836.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,3631.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3798.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12886.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3703.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,11529.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,8138.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3798.06,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8138.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3703.84,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3631.22,12886.28,
"LAPAROSCOPY, SURGICAL; CHOLECYS W/CHOLAN",9047563,CDM,360,RC,,,outpatient,,,1727,1122.55,,1157.09,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,483.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,462.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,483.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1260.71,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1554.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,480.81,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1381.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1295.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,488.4,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,462.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,483.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1640.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,471.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1467.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1036.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,483.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1036.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,471.57,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,462.32,1640.65,
CHOLECYSTECTOMY (IP ONLY),9047600,CDM,360,RC,,,outpatient,,,2259,1468.35,,1513.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,632.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,604.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,632.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1649.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2033.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,628.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1807.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1694.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,638.85,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,604.73,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,632.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2146.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,616.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1920.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1355.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1355.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,604.73,2146.05,
CHOLECYSTECTOMY; W/CHOLANGIOGRAM (IP),9047605,CDM,360,RC,,,outpatient,,,3384.5,2199.93,,2267.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,947.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,906.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,947.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2470.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3046.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,942.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2707.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2538.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,957.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,906.03,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,947.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3215.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,924.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2876.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2030.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,947.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2030.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,924.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,906.03,3215.28,
EXPLORATION RETROPER W W/O BIOPSY (IP),9049010,CDM,360,RC,,,outpatient,,,2820.5,1833.33,,1889.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,789.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,755.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,789.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2058.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2538.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,785.25,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2256.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2115.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,797.64,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,755.05,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,789.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2679.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,770.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2397.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1692.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,789.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1692.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,770.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,755.05,2679.48,
ABDOMINAL PARACENTESIS W/O IMAGING,9049082,CDM,360,RC,,,outpatient,,,1287.5,836.88,,862.63,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,939.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1158.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,358.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1030,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,965.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,364.11,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,344.66,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1223.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1094.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,772.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,351.55,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,344.66,1223.13,
ABD PARACENTESIS DIAG/THERAP W/IMAGING G,9049083,CDM,360,RC,,,outpatient,,,786,510.9,,526.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,220.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,210.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,220.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,573.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,707.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,218.83,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,628.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,589.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,222.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,210.41,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,220.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,746.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,214.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,668.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,471.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,220.08,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,471.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,214.62,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,210.41,746.7,
EXCIS/DESTRUCTOPEN INTRAB TUM/CY (IP),9049203,CDM,360,RC,,,outpatient,,,1819,1182.35,,1218.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,509.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,486.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,509.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1327.87,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1637.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,506.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1455.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1364.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,514.41,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,486.95,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,509.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1728.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,496.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1546.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1091.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,509.32,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1091.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,496.69,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,486.95,1728.05,
UMBILECTOMY OMPHALECTOMY EXC UMBILICUS,9049250,CDM,360,RC,,,outpatient,,,5783.5,3759.28,,3874.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1548.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4221.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5205.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1610.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4626.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4337.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1635.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1548.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5494.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1579.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4915.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3470.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3470.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1579.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1548.24,5494.33,
"LAPAROSCOPY, ABDOMEN, PERITONEUM",9049320,CDM,360,RC,,,outpatient,,,5106.6,3319.29,,3421.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1429.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1367.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1429.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3727.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4595.94,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1421.72,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4085.28,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3829.95,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1444.15,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1367.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1429.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4851.27,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1394.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4340.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3063.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1429.85,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3063.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1394.38,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1367.04,4851.27,
"LAPAROSCOPY, ASPIRATION",9049322,CDM,360,RC,,,outpatient,,,8521.5,5538.98,,5709.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2386.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2281.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2386.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6220.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7669.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2372.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6817.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6391.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2409.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2281.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2386.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8095.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2326.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7243.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5112.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2386.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5112.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2326.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2281.21,8095.43,
"INSERTION GASTROSTOMY TUBE, PERCUTA",9049440,CDM,360,RC,,,outpatient,,,2893,1880.45,,1938.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,774.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2111.89,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2603.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,805.44,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2314.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2169.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,818.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,774.46,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2748.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,789.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2459.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1735.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,810.04,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1735.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,789.95,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,774.46,2748.35,
"REPAIR INITIAL INGUINAL HERNIA, 6mo <5",9049500,CDM,360,RC,,,outpatient,,,7582,4928.3,,5079.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5534.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6823.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2110.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6065.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5686.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2144.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7202.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6444.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2029.7,7202.9,
"REPAIR INITIAL INGUINAL HERNIA, AGE 5 >",9049505,CDM,360,RC,,,outpatient,,,1356,881.4,,908.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,379.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,363,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,379.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,989.88,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1220.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,377.52,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1084.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1017,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,383.48,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,363,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,379.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1288.2,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,370.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1152.6,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,813.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,379.68,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,813.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.26,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,363,1288.2,
REPAIR INITIAL INGUINAL HERNIA AGE 5 >,9049507,CDM,360,RC,,,outpatient,,,1077,700.05,,721.59,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,301.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,288.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,301.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,786.21,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,969.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,299.84,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,861.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,807.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,304.58,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,288.31,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,301.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1023.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,294.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,915.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,646.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,646.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,288.31,1023.15,
REPAIR RECURRENT INGUINAL HERNIA; REDUC,9049520,CDM,360,RC,,,outpatient,,,865,562.25,,579.55,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,242.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,231.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,242.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,631.45,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,778.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,240.82,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,692,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,648.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,244.62,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,231.56,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,242.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,821.75,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,236.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,735.25,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,519,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,519,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,236.19,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,231.56,821.75,
"REPAIR RECURR ING HERNIA, ANY AGE,",9049521,CDM,360,RC,,,outpatient,,,3520,2288,,2358.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,985.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,942.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,985.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2569.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3168,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,979.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2816,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2640,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,995.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,942.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,985.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3344,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,961.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2992,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2112,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,985.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2112,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,961.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,942.3,3344,
REPAIR INGUINAL HERNIA SLIDING ANY AGE,9049525,CDM,360,RC,,,outpatient,,,8155,5300.75,,5463.85,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2283.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2183.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2283.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5953.15,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7339.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2270.41,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6524,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6116.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2306.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2183.09,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2283.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7747.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2226.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6931.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4893,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2283.4,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4893,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2226.75,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2183.09,7747.25,
"REPAIR INITIAL FEMORAL HERNIA, INCAR/STR",9049553,CDM,360,RC,,,outpatient,,,3520,2288,,2358.4,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,985.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,942.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,985.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2569.6,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3168,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,979.99,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2816,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2640,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,995.46,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,942.3,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,985.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3344,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,961.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2992,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2112,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,985.6,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2112,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,961.15,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,942.3,3344,
REPAIR INITIAL INCISIONAL/VENTRAL HERNIA,9049560,CDM,360,RC,,,outpatient,,,2729.5,1774.18,,1828.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,730.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1992.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2456.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,759.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2183.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2047.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,771.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,730.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2593.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,745.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2320.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1637.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1637.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,745.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,730.69,2593.03,
REPAIR INITIAL INCISIONAL/VENTRAL HERNIA,9049561,CDM,360,RC,,,outpatient,,,2729.5,1774.18,,1828.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,730.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1992.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2456.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,759.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2183.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2047.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,771.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,730.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2593.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,745.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2320.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1637.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1637.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,745.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,730.69,2593.03,
REPAIR RECUR INCISIONAL/VENTRAL HERNIA,9049565,CDM,360,RC,,,outpatient,,,7582,4928.3,,5079.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5534.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6823.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2110.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6065.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5686.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2144.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7202.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6444.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2029.7,7202.9,
REPAIR RECURR INCISIONAL OR VENTRAL HERN,9049566,CDM,360,RC,,,outpatient,,,7582,4928.3,,5079.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5534.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6823.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2110.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6065.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5686.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2144.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7202.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6444.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2029.7,7202.9,
IMPLANTATION OF MESH FOR HERNIA REPAIR,9049568,CDM,360,RC,,,outpatient,,,2729.5,1774.18,,1828.77,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,730.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1992.54,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2456.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,759.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2183.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2047.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,771.9,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,730.69,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2593.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,745.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2320.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1637.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,764.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1637.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,745.3,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,730.69,2593.03,
"REPAIR EPIGASTRIC HERNIA, REDUCIBLE",9049570,CDM,360,RC,,,outpatient,,,7582,4928.3,,5079.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5534.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6823.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2110.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6065.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5686.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2144.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7202.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6444.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2029.7,7202.9,
REPAIR EPIGASTRIC HERNIA;INCARC OR STRAN,9049572,CDM,360,RC,,,outpatient,,,7582,4928.3,,5079.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5534.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6823.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2110.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6065.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5686.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2144.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7202.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6444.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2029.7,7202.9,
UMBILICAL HERNIA REPAIR,9049580,CDM,360,RC,,,outpatient,,,1117,726.05,,748.39,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,312.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,299.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,312.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,815.41,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1005.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,310.98,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,893.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,837.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,315.89,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,299.02,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,312.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1061.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,305,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,949.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,670.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312.76,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,670.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,305,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,299.02,1061.15,
"REPAIR UMBLICIAL HERNIA, <5yrs, INCARCER",9049582,CDM,360,RC,,,outpatient,,,7582,4928.3,,5079.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5534.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6823.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2110.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6065.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5686.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2144.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7202.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6444.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2029.7,7202.9,
"REPAIR UMBLICIAL HERNIA, AGE 5 & > REDUC",9049585,CDM,360,RC,,,outpatient,,,682.5,443.63,,457.28,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,191.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,182.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,191.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,498.23,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,614.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,190.02,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,546,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,511.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,193.01,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,182.71,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,191.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,648.38,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,186.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,580.13,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,409.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,191.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,409.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186.36,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,182.71,648.38,
REPAIR UMBILICAL HERNIA; 5 OR >; INCARCE,9049587,CDM,360,RC,,,outpatient,,,7582,4928.3,,5079.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5534.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6823.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2110.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6065.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5686.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2144.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7202.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6444.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2029.7,7202.9,
LAP SURG REPAIR UMBILICAL HERNIA,9049652,CDM,360,RC,,,outpatient,,,9591.3,6234.35,,6426.17,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2685.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2567.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2685.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7001.65,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8632.17,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2670.29,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7673.04,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7193.48,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2712.42,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2567.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2685.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9111.74,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2618.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8152.61,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5754.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2685.56,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5754.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2618.94,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2567.59,9111.74,
LAP SURG REPAIR HERNIA,9049653,CDM,360,RC,,,outpatient,,,15985.5,10390.58,,10710.29,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,4475.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4279.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4475.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,11669.42,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,14386.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,4450.49,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,12788.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,11989.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,4520.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,4279.32,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,4475.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15186.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,4364.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,13587.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,9591.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4475.94,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9591.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4364.91,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4279.32,15186.23,
LAP SURG REPAIR INCISIONAL HERNIA REDUC,9049654,CDM,360,RC,,,outpatient,,,21415,13919.75,,14348.05,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,5996.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5732.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5996.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,15632.95,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,19273.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,5962.11,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,17132,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,16061.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,6056.16,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,5732.8,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,5996.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,20344.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,5847.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,18202.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,12849,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5996.2,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,12849,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5847.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5732.8,20344.25,
UNLISTED LAPAROSCOPY PROCEDURE,9049659,CDM,360,RC,,,outpatient,,,8521.5,5538.98,,5709.41,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2386.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2281.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2386.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6220.7,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7669.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2372.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6817.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6391.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2409.88,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2281.21,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2386.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8095.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2326.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7243.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5112.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2386.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5112.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2326.83,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2281.21,8095.43,
"UNLISTED PROCEDURE, ABD,PERITON, OMENT",9049999,CDM,360,RC,,,outpatient,,,5783.5,3759.28,,3874.95,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1548.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4221.96,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5205.15,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1610.17,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4626.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4337.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1635.57,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1548.24,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5494.33,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1579.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4915.98,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3470.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1619.38,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3470.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1579.2,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1548.24,5494.33,
DRAINAGE PERIRENAL OR RENAL ABCESS; OPEN,9050020,CDM,360,RC,,,outpatient,,,5959,3873.35,,3992.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4350.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5363.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1659.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4767.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4469.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1685.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5661.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5065.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1595.22,5661.05,
"BLADDER IRRIGATION; SIMPLE,LAVAGE INSTIL",9051700,CDM,360,RC,,,outpatient,,,477.5,310.38,,319.93,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,127.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,348.58,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,429.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,132.94,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,382,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,358.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,135.04,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,127.83,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,453.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,130.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,405.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,286.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.7,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,286.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.39,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,127.83,453.63,
CYSTOURETHROSCOPY,9052000,CDM,360,RC,,,outpatient,,,1591.5,1034.48,,1066.31,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,445.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,426.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,445.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1161.8,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1432.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,443.08,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1273.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1193.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,450.08,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,426.04,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,445.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1511.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,434.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1352.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,445.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,954.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,434.56,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,426.04,1511.93,
CYSTOURETHROSCOPY W/URETERAL CATH,9052005,CDM,360,RC,,,outpatient,,,5959,3873.35,,3992.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4350.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5363.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1659.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4767.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4469.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1685.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5661.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5065.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1595.22,5661.05,
CYSTOURETHROSCOPY W/BIOPSY,9052204,CDM,360,RC,,,outpatient,,,5959,3873.35,,3992.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4350.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5363.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1659.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4767.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4469.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1685.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5661.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5065.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1595.22,5661.05,
CYSTOURETHROSCOPY W/FULGURATION TRIGON,9052214,CDM,360,RC,,,outpatient,,,5959,3873.35,,3992.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4350.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5363.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1659.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4767.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4469.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1685.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5661.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5065.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1595.22,5661.05,
CYSTOURETHROSCOPY W/FULGURATION/TX,9052224,CDM,360,RC,,,outpatient,,,5959,3873.35,,3992.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4350.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5363.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1659.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4767.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4469.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1685.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5661.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5065.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1595.22,5661.05,
"CYSTOURETHROSCOPY,W/FULGRATION/RESECT",9052234,CDM,360,RC,,,outpatient,,,5959,3873.35,,3992.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4350.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5363.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1659.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4767.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4469.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1685.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5661.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5065.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1595.22,5661.05,
"CYSTOURETHROSCOPY,MED BLADDER TUMOR(S)",9052235,CDM,360,RC,,,outpatient,,,5959,3873.35,,3992.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4350.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5363.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1659.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4767.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4469.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1685.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5661.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5065.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1595.22,5661.05,
CYSTOURETHROSCOPY W/DILATION BLADDER,9052260,CDM,360,RC,,,outpatient,,,3531.5,2295.48,,2366.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,988.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,945.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,988.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2578,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3178.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,983.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2825.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2648.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,998.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,945.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,988.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3354.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,964.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3001.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2118.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,988.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2118.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,964.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,945.38,3354.93,
CYSTOURETHROSCOPY W/CAL OR DILA OF URET,9052281,CDM,360,RC,,,outpatient,,,3531.5,2295.48,,2366.11,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,988.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,945.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,988.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2578,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3178.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,983.2,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2825.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2648.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,998.71,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,945.38,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,988.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3354.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,964.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3001.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2118.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,988.82,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2118.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,964.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,945.38,3354.93,
CYSTOURETHROSOCPY;W/TX URETERAL STRICT,9052341,CDM,360,RC,,,outpatient,,,5959,3873.35,,3992.53,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4350.07,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,5363.1,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1659.03,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4767.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4469.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1685.21,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1595.22,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5661.05,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,5065.15,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1668.52,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3575.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1627.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1595.22,5661.05,
BIOPSY OF URETHRA,9053200,CDM,360,RC,,,outpatient,,,4807.5,3124.88,,3221.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1286.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3509.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4326.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1338.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3846,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3605.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1359.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1286.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4567.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1312.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4086.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2884.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2884.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1312.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1286.97,4567.13,
"SLITTING OF PREPUCE, DORSAL/LATERAL",9054001,CDM,360,RC,,,outpatient,,,4807.5,3124.88,,3221.03,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1286.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3509.48,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4326.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1338.45,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3846,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3605.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1359.56,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1286.97,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4567.13,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1312.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4086.38,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2884.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1346.1,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2884.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1312.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1286.97,4567.13,
"DESTRUCTION LESION, PENIS, EXTENSIVE",9054065,CDM,360,RC,,,outpatient,,,4426,2876.9,,2965.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1184.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3230.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3983.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1232.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3540.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3319.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1251.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1184.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4204.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1208.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3762.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2655.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2655.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1208.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1184.84,4204.7,
CIRCUMCISION  W/REGIONAL BLOCK,9054150,CDM,360,RC,,,outpatient,,,5297,3443.05,,3548.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3866.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4767.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1474.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3972.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1497.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5032.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4502.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1418.01,5032.15,
CIRCUMCISION; EXCEPT NEWBORN,9054161,CDM,360,RC,,,outpatient,,,400,260,,268,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,112,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,107.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,112,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,292,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,360,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,111.36,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,320,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,300,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,113.12,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,107.08,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,112,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,380,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,109.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,340,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,240,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,240,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.22,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,107.08,380,
REPAIR INCOMPLETE CIRCUMCISION,9054163,CDM,360,RC,,,outpatient,,,5297,3443.05,,3548.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3866.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4767.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1474.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3972.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1497.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5032.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4502.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1418.01,5032.15,
"ORCHIECTOMY,SIMPLE",9054520,CDM,360,RC,,,outpatient,,,5297,3443.05,,3548.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3866.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4767.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1474.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3972.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1497.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5032.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4502.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1418.01,5032.15,
INCISION & DRAINAGE OF EPIDIDYMIS TESTIC,9054700,CDM,360,RC,,,outpatient,,,5417.5,3521.38,,3629.73,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1516.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1450.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1516.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3954.78,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4875.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1508.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4334,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,4063.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1532.07,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1450.26,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1516.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5146.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1479.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4604.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3250.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1516.9,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3250.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1479.27,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1450.26,5146.63,
EXCISION SPERMATOCELE W/ W/O EPIDIDYMECT,9054840,CDM,360,RC,,,outpatient,,,5297,3443.05,,3548.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3866.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4767.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1474.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3972.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1497.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5032.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4502.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1418.01,5032.15,
EPIDIDYMECTOMY; UNILATERAL,9054860,CDM,360,RC,,,outpatient,,,5297,3443.05,,3548.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3866.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4767.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1474.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3972.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1497.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5032.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4502.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1418.01,5032.15,
PUNCTURE ASPIRATION OF HYDROCELE,9055000,CDM,360,RC,,,outpatient,,,1079.5,701.68,,723.27,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,288.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,788.04,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,971.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,300.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,863.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,809.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,305.28,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,288.98,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1025.53,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,294.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,917.58,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,647.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,647.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,294.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,288.98,1025.53,
EXCISION HYDROCELE; UNILATERAL,9055040,CDM,360,RC,,,outpatient,,,9812.5,6378.13,,6574.38,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2747.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2626.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2747.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7163.13,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,8831.25,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2731.88,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,7850,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,7359.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2774.98,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2626.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2747.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,9321.88,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2679.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,8340.63,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5887.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2747.5,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5887.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2679.35,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2626.81,9321.88,
REPAIR TUNICA VAGINALIS HYDROCELE,9055060,CDM,360,RC,,,outpatient,,,5297,3443.05,,3548.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3866.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4767.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1474.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3972.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1497.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5032.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4502.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1418.01,5032.15,
DRAINAGE OF SCROTAL WALL ABSCESS,9055100,CDM,360,RC,55100,HCPCS,outpatient,,,2265.5,1472.58,,1517.89,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1653.82,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2038.95,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,630.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1812.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1699.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,640.68,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,606.47,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2152.23,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1925.68,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,634.34,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1359.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,618.6,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,606.47,2152.23,
SCROTAL EXPLORATION,9055110,CDM,360,RC,,,outpatient,,,5297,3443.05,,3548.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3866.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4767.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1474.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3972.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1497.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5032.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4502.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1418.01,5032.15,
"VASECTOMY, UNILATERAL OR BILATERAL",9055250,CDM,360,RC,,,outpatient,,,1907,1239.55,,1277.69,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,533.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,510.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,533.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1392.11,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1716.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,530.92,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1525.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1430.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,539.3,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,510.5,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,533.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1811.65,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,520.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1620.95,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1144.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,533.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1144.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.71,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,510.5,1811.65,
EXCISION HYDROCELE SPERMATIC CORD UNILAT,9055500,CDM,360,RC,,,outpatient,,,5297,3443.05,,3548.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3866.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4767.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1474.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3972.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1497.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5032.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4502.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1418.01,5032.15,
EXCISION LESION SPERMATIC CORD,9055520,CDM,360,RC,,,outpatient,,,5297,3443.05,,3548.99,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3866.81,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4767.3,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1474.73,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4237.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3972.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1497.99,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1418.01,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5032.15,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4502.45,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1483.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3178.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1446.37,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1418.01,5032.15,
EXCISION VARICOCELE W/HERNIA REPAIR,9055540,CDM,360,RC,,,outpatient,,,7582,4928.3,,5079.94,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5534.86,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,6823.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2110.89,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6065.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,5686.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2144.19,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2029.7,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7202.9,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,6444.7,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2122.96,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4549.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2070.29,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2029.7,7202.9,
"BIOPSY,PROSTATE;NEEDLE/PUNCH,SING/MULT",9055700,CDM,360,RC,,,outpatient,,,3020.5,1963.33,,2023.74,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,845.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,808.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,845.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2204.97,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,2718.45,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,840.93,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,2416.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,2265.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,854.2,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,808.59,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,845.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2869.48,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,824.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2567.43,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1812.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,845.74,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1812.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,824.76,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,808.59,2869.48,
MARSUPIALIZATION BARTHOLIN'S GLAND CYST,9056440,CDM,360,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
"DESTRUCTION LESION VULVA, SIMPLE",9056501,CDM,360,RC,,,outpatient,,,4426,2876.9,,2965.42,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1184.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3230.98,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3983.4,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1232.23,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3540.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3319.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1251.67,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1184.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4204.7,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1208.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3762.1,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2655.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1239.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2655.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1208.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1184.84,4204.7,
EXC OF BARTHOLIN'S GLAND OR CYST,9056740,CDM,360,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
PRINEOPLASTRY REPAIR,9056810,CDM,360,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
BIOPSY OF VAGINAL MUCOSA; SIMPLE,9057100,CDM,360,RC,,,outpatient,,,1554.5,1010.43,,1041.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1134.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1399.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,432.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1243.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1165.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,439.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,416.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1476.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,424.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1321.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,932.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,932.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,424.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,416.14,1476.78,
PELVIC EXAM UNDER ANESTHESIA,9057410,CDM,360,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
COLPOSCOPY VAGINOSCOPY,9057452,CDM,360,RC,,,outpatient,,,371.5,241.48,,248.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,271.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,334.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,103.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,297.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,278.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,105.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,99.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,352.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,101.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,315.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,222.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,222.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,99.45,352.93,
"BIOPSY OF CERVIX, SINGLE/MULTI",9057500,CDM,360,RC,,,outpatient,,,1554.5,1010.43,,1041.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1134.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1399.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,432.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1243.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1165.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,439.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,416.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1476.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,424.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1321.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,932.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,932.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,424.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,416.14,1476.78,
ENDOCERVICAL CURRETTAGE,9057505,CDM,360,RC,,,outpatient,,,1554.5,1010.43,,1041.52,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,416.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1134.79,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1399.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,432.79,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1243.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1165.88,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,439.61,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,416.14,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1476.78,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,424.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1321.33,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,932.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,435.26,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,932.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,424.46,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,416.14,1476.78,
"CONIZATION OF CERVIX, W W/O FULGRATION",9057522,CDM,360,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
"D&C, DIAG/THERAPEUTIC, NON OB",9058120,CDM,360,RC,,,outpatient,,,4541.5,2951.98,,3042.81,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3315.3,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4087.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1264.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3633.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3406.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1284.34,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1215.76,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4314.43,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3860.28,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1271.62,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2724.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1240.08,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1215.76,4314.43,
REMOVAL IUD,9058301,CDM,360,RC,,,outpatient,,,371.5,241.48,,248.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,99.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,271.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,334.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,103.43,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,297.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,278.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,105.06,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,99.45,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,352.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,101.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,315.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,222.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,222.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,99.45,352.93,
HYSTEROSCOPY DIAGNOSTIC,9058555,CDM,360,RC,,,outpatient,,,5250,3412.5,,3517.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1470,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1405.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1470,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3832.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4725,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1461.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4200,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3937.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1484.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1405.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1470,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4987.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1433.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4462.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1470,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1433.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1405.43,4987.5,
"HYSTEROSCOPY, BIOPSY",9058558,CDM,360,RC,,,outpatient,,,5250,3412.5,,3517.5,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1470,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1405.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1470,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3832.5,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,4725,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1461.65,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,4200,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3937.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1484.7,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1405.43,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1470,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,4987.5,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1433.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,4462.5,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,3150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1470,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1433.54,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1405.43,4987.5,
"HYSTERSCOPY, SURGICAL; REMOV LEIOMYOMATA",9058561,CDM,360,RC,,,outpatient,,,8353,5429.45,,5596.51,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,2338.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2236.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2338.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6097.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,7517.7,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,2325.54,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,6682.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,6264.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,2362.23,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2236.1,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,2338.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7935.35,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2280.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,7100.05,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,5011.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2338.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,5011.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2280.82,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2236.1,7935.35,
LIGATION OR TRANSECTION FALLOPIAN TUBE(S,9058600,CDM,360,RC,,,outpatient,,,2172,1411.8,,1455.24,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,608.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,581.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,608.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1585.56,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1954.8,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,604.7,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1737.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1629,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,614.24,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,581.44,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,608.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2063.4,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,593.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1846.2,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1303.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,608.16,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1303.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,593.07,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,581.44,2063.4,
"LAPAROSCOPY, SURGICAL;W/LYSIS",9058660,CDM,360,RC,,,outpatient,,,10884.5,7074.93,,7292.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7945.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9796.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3030.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8707.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8163.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3078.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10340.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9251.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2913.78,10340.28,
LAP RMVL ADNEXAL STRUXS,9058661,CDM,360,RC,,,outpatient,,,10884.5,7074.93,,7292.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7945.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9796.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3030.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8707.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8163.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3078.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10340.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9251.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2913.78,10340.28,
LAP FULG/EXC OVARY VISCERA/PERITONEAL SU,9058662,CDM,360,RC,,,outpatient,,,10884.5,7074.93,,7292.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7945.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9796.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3030.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8707.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8163.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3078.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10340.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9251.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2913.78,10340.28,
"LAPAROSCOPY, SURG; W/OCCLUSION OVIDUCTS",9058670,CDM,360,RC,,,outpatient,,,11071.5,7196.48,,7417.91,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3100.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2963.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3100.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,8082.2,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9964.35,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3082.39,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8857.2,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8303.63,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3131.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2963.84,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3100.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10517.93,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,3023.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9410.78,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6642.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3100.02,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6642.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3023.12,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2963.84,10517.93,
"LAPAROSCOPY, SURG; W/OCCLUSION OVIDUCTS",9058671,CDM,360,RC,,,outpatient,,,10884.5,7074.93,,7292.62,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,7945.69,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,9796.05,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,3030.33,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,8707.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,8163.38,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,3078.14,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,2913.78,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,10340.28,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,9251.83,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3047.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,6530.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2972.06,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,2913.78,10340.28,
NEUROPLASTY; CARPAL TUNNEL,9064721,CDM,360,RC,,,outpatient,,,4197.5,2728.38,,2812.33,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,1175.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1123.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1175.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3064.18,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,3777.75,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,1168.62,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,3358,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,3148.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,1187.05,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,1123.67,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,1175.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,3987.63,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,1146.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,3567.88,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,2518.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1175.3,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,2518.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1146.14,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1123.67,3987.63,
EXCISION LESION EYELID W/O CLOSURE,9067840,CDM,360,RC,,,outpatient,,,2009.5,1306.18,,1346.37,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,562.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,537.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,562.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1466.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,1808.55,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,559.46,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,1607.6,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,1507.13,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,568.29,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,537.94,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,562.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1909.03,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,548.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,1708.08,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,1205.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,562.66,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,1205.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,548.7,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,537.94,1909.03,
REMOVAL FB EXTERNAL AUD CANAL W/GEN ANES,9069205,CDM,360,RC,,,outpatient,,,778,505.7,,521.26,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,217.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,208.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,217.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,567.94,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,700.2,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,216.6,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,622.4,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,583.5,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,220.02,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,208.27,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,217.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,739.1,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,212.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,661.3,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,466.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.84,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,466.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.44,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,208.27,739.1,
REMOVAL DEVITALIZED TISSUE FROM WOUND(S),9097597,CDM,360,RC,,,outpatient,,,201,130.65,,134.67,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,146.73,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,180.9,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,55.96,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,160.8,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,150.75,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,56.84,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,53.81,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,190.95,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,170.85,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.28,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.89,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,53.81,190.95,
DEBRIDEMENT OPEN WOUND @ ADD'L 20sq cm,9097598,CDM,360,RC,,,outpatient,,,335,217.75,,224.45,67,,,percent of total billed charges,67% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,244.55,73,,,percent of total billed charges,73% of total billed charges for outpatient setting,301.5,90,,,percent of total billed charges,90% of total billed charges for outpatient setting,93.27,27.84,,,percent of total billed charges,27.84% of total billed charges which is 104% of the GA Medicaid CCR rate for outpatient setting,268,80,,,percent of total billed charges,80% of total billed charges for outpatient setting,251.25,75,,,percent of total billed charges,75% of total billed charges for outpatient setting,94.74,28.28,,,percent of total billed charges,28.28% of total billed charges which is 101% of the CMS Medicare rate for outpatient setting,89.68,26.77,,,percent of total billed charges,26.77% of total billed charges which is 100% of the GA Medicaid CCR rate for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,318.25,95,,,percent of total billed charges,95% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,284.75,85,,,percent of total billed charges,85% of total billed charges for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.8,28,,,percent of total billed charges,28% of total billed charges which is 100% of the CMS Medicare rate for outpatient setting,201,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.47,27.31,,,percent of total billed charges,27.31% of total billed charges which is 102% of the GA Medicaid CCR rate for outpatient setting,89.68,318.25,